Nov. 14, 2013 -- The question of the day is: Should I be on a statin?
New guidelines released Tuesday by the American Heart Association and the American College of Cardiology change the standards for who should be taking these cholesterol-lowering drugs.
As doctors follow the new guidelines, more people are expected to be put on statins.
The guidelines include new weight and lifestyle measures to lower the risk of having a heart attack and stroke. The guidelines also recommend that doctors focus on overall risks to the heart and less on cholesterol numbers.
Three doctors give their perspectives on the guidelines.
Q: What's behind the change?
"The new focus is on risk" rather than simply a cholesterol number, says Timothy Henry, MD, director of cardiology at the Cedars-Sinai Heart Institute. "This is a plan for dealing with cardiovascular risk.''
"It starts with knowing what our risk is and then helping to manage that risk, starting with a healthy lifestyle. It starts with exercise, losing weight [if necessary], and eating the right foods. It's also being aware of the risks."
Q: What was wrong with using cholesterol numbers, as we have in the past?
"Nothing was wrong, [it's] just a different approach or focus," Henry says. "Rather than numbers, it's moving the focus to understanding risk and with a focus on a heart-healthy lifestyle.''
Q: Who is likely to get a statin now?
Just as in the past, people diagnosed with heart disease will start taking a statin.
New to the guidelines: People with extremely high LDL, or ''bad'' cholesterol, and all middle-aged people with type 2 diabetes will be advised to take a statin.
Also, men and women 40 to 75 who have an estimated 10-year risk of heart or blood vessel problems of 7.5% or higher will be recommended a statin.
Q: How is that risk determined?
To determine that risk, doctors use a calculator that figures out the chances of having heart problems in the next 10 years. It is also available online here. (You must know your cholesterol numbers and blood pressure to use it.)
The calculator takes into account cholesterol numbers, age, blood pressure, smoking habits, and use of blood pressure medicines. All of these things affect your chance of having heart problems.
The risk calculator does not apply if you already have heart disease.
source : New Cholesterol Drug Guidelines: Q&A
