U.S. Doctors push for cholesterol drugs for patients

Written by Alyssa Clark

With the classic relationship between heart problems and cholesterol levels, people are curious as to the recent shift in attention of those researching and developing ways to combat the problem of heart disease. Interestingly enough with the nation’s recent release of heart disease prevention guidelines in over a decade, the public sees a shift taking place in targeting heart disease: health professionals are urging people to focus more on general “risk”, rather than specifically targeted cholesterol triggers.

This broad definition of “risk” is calculated by researchers and healthcare professionals, considering factors like age, gender, race and smoker/non-smoker, in order to determine a person’s predisposition for high cholesterol, and those with a lower predisposition. These guidelines have been developed to help take preventative measures against strokes not just heart attacks, and help people be preventative rather than reacting to these tragedies after the fact. In order to do so, the threshold for those who will be prescribed medication is lowered, in order to reduce risk across the board for patients. Drugs such as Lipitor and Zocor have so far identified four groups of people that they have helped the most.

Ultimately, the results from focusing on “risk” and lowering the threshold for preventative medication subscription has resulted in twice as many Americans or one-third of all adults being advised to take statins; which lower heart risks and cholesterol.

"The emphasis is to try to treat more appropriately," said Dr. Neil Stone, the Northwestern University doctor who headed the cholesterol guideline panel. "We're going to give statins to those who are the most likely to benefit."

Healthcare professionals and doctors alike are estimating that the new risk-centered approach will limit how many people are put on statins simply due to their cholesterol number. With the new advice in tow, one-third of U.S. adults, which breaks down into 44 percent of men and 22 percent of women, would be considered as meeting the threshold to consider taking statins. As of now, statins are only recommended for 15 percent of active adults.

They say statins do the most good for:

—People who already have heart disease.

—Those with LDL of 190 or higher, usually because of genetic risk.

—People ages 40 to 75 with Type 2 diabetes.

—People ages 40 to 75 who have an estimated 10-year risk of heart disease of 7.5 percent or higher, based on the new formula. (This means that for every 100 people with a similar risk profile, seven or eight would have a heart attack or stroke within 10 years.)

"It will be controversial, there's no question about it. For as long as I remember, we've told physicians and patients we should treat their cholesterol to certain goal levels," said the Cleveland Clinic's Dr. Steven Nissen. "There is concern that there will be a lot of confusion about what to do."

The government’s National Heart, Lung and Blood Institute appointed panelists who are experts in their respective fields to write the new guidelines in 2008, and they were delivered this past Tuesday by the American Heart Association and American College of Cardiology.

"It is practically impossible to find a large group of outside experts in the field who have no relationships to industry," said Dr. George Mensah of the heart institute. He called the guidelines "a very important step forward" based on solid evidence, and said the public should trust them.

About the Author

Alyssa Clark is the Editor of Healthcare Global