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We at American Medical Resource Institute are pleased to see that the American College of Cardiology and the American Heart Association have changed their guidelines for who should take statins, among the most commonly prescribed drugs in America.
We applaud the nation’s two leading heart organizations, which are now recommending intensively treating the sickest patients with the highest risk of suffering a heart attack or stroke with powerful cholesterol-busting drugs.
The new guidelines recommend statins to 4 groups of patients who have the greatest odds of preventing heart attack and stroke on the drugs. They are 1.) People with heart disease 2.) People with low density lipoprotein, or LDL cholesterol, of 190 mg/dL or higher 3.) People with Type 2 diabetes who are between 40 and 75 years old, and 4.) Patients with an estimated 10-year risk of heart disease of 7.5 percent or higher who are between the ages of 40 and 75.
The old approach emphasized lowering cholesterol numbers; people were supposed to aim for a total cholesterol level of under 200, keeping their LDL at or below 130 for average people and below 100 for those seen at risk of a heart attack. People at highest risk, such as heart attack survivors, were advised to keep their LDL at 70 or below.
The guideline change, the first since 2004, is based on a 4-year review of evidence and counts strokes, as well as heart attacks, in its risk calculations.
We like the straightforward approach of identifying a problem and then treating it. We don’t believe in blindly using algorithms and chasing numbers.
This new approach to prescribing statins is consistent with our approach to emergency cardiac care. This is the way we present our course material and it is why we use case studies -- to help you identify the underlying pathology, and then treat the problem.
We think it may be a long while before we see any material changes in the way patients are treated. There will still be a lot of physicians who will pull out their prescription pads and write an order for the statin -- that certainly is the easiest way.
We believe the reality is that lifestyle changes are the only way to get a sustainable result. For healthcare providers, this means more talks with patients, more support networks, more rehabilitation and habilitation. It means helping patients adapt to a healthier lifestyle, resulting in lower risk.
Chasing numbers and not changing lifestyle won’t work in the long run.
Experts say it is unclear whether these guideline changes will mean more or fewer people will end up taking statins.
According to 2011 estimates from Harvard Medical School, 32 million Americans take statins.
Some of the more serious potential side effects of these powerful drugs include liver damage, muscle pains, as well as neurological side effects. Recent research has linked statins to cataract risk. Some of the more common side effects include muscle and joint aches, nausea, diarrhea and and constipation.
We wonder what you think these guideline changes will mean to you and your practice. Please share with us what you’ve done or seen that has made a difference.
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