By: William Brandon, MD MPH MHA
Site Medical Director
Harbor Community Health Center-Hyannis
Most of you probably heard on the news that the guidelines for treating high cholesterol were changing. The news highlighted that many more people would be asked to take statins, the common drug used to lower cholesterol, but some people taking the medication now wouldn’t have to take it anymore. The news also emphasized that there wouldn’t be such an emphasis on reaching a certain number for LDL what is considered your “bad” cholesterol.
After reviewing the actual guidelines put out by the American Heart Association and American College of Cardiology I came away with the following points:
1. We need to include people with strokes as having high risk for a heart attack and treat them aggressively.
2. We should focus on people with Diabetes who are over the age of 40
3. We need to work harder on lifestyle modification in other words don’t smoke, eat healthy foods, exercise at least 4 times a week and keep your weight down
Another new concept was that everyone should have their 10 year and lifetime risk of having a heart attack calculated and then those with risks over 7.5% should be treated with statins. This concept has come under attack by some researchers in Boston who feel the tool overestimates some people’s risk.
It is unclear whether these changes will make doctors or patients change the way they are treated. On a personal note I have taken statins for several years mainly because of a strong Family History of Coronary Artery Disease and a mildly elevated LDL. I ran myself through the calculator and found I only have a 2.5% 10 year chance of having a problem. By these new guidelines, since I don’t have Diabetes, I can probably stop my medication. I am hesitant given that that my Father, both grandfathers and some uncles had heart attacks in their 50s. For now I will probably continue to take the medication. Everyone on these meds should discuss it with their providers and you should probably ask to have your 10 year risk calculated. This is certainly not an issue that is clear and I am sure much debate to come.