In November 2013, the American
Heart Association (AHA) and the American College of Cardiology (ACC) released new guidelines
for cholesterol therapy in adults 20-79 years old. The guidelines were based on
solid medical evidence but, nonetheless, generated a lot of controversy and
even opposing opinions from experts in the field. On one hand, the guidelines
argue for limiting some of the cholesterol testing we now use as a guide for
therapy. On the other hand, the guidelines recommend therapy (the use of statin
drugs) for certain groups of patients, regardless of their blood cholesterol
levels. The controversy which evolved was covered in articles in the New York
Times last November. The two titles convey the opposing messages: Experts Reshape Treatment Guide for
Cholesterol and Don’t
Give More Patients Statins.
Some of the best known statin drugs
now in use include: Atorvastatin (Lipitor), Rosuvastatin (Crestor), Lovastatin
and Simvastatin.
A study on the subject was published in the New England Journal of Medicine of 3/20/2014
by Michael J. Pencina, PhD, from the Duke Clinical Research
Institute. It reports that the new
guidelines would increase the number of
U.S. adults eligible for statin therapy by almost 13 million, and that most adults
between 60-75 years old would become candidates for treatment. I also refer to
the guidelines in my blog of last November, Statins,
To Take Or Not To Take.
The guidelines use a newly updated, computerized cardiac
risk assessment tool, in deriving its recommendations. We use the same tool in
our office.