Should You Be On A Statin Drug? The New Rules

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Generic Statin (credit: Dr. Dave Hnida)

Generic Statin (credit: Dr. Dave Hnida)

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Written by Dr. Dave Hnida, CBS4 Medical Editor

A big shakeup in the world of medicine today — involving you and your heart.

The American Heart Association and the American College of Cardiology jointly announced some new guidelines for the use of statin drugs — the medicines that lower cholesterol.

They say the old rules are worthless, and you should be taking statins only if you fit certain criteria.

That makes it sound like the drugs are overused, and therefore, the number of people gobbling these tabs each day will drop. Not so. The number may actually double.

Right now, about 15 percent of Americans take a daily statin. With these guidelines, the number would a little more than double to 31 percent — just about one in three Americans.

Their reasoning is simple. The experts say too many people take statins just because their cholesterol is high — even by a little bit. So, the thinking is, let’s hold off pushing these drugs onto everyone and their brothers — and instead give it to the people at highest risk, and with the highest numbers.

Here’s the new breakdown as to who should be on a statin, at least according to the experts:

1. If you have a known history of heart disease.

2. If you have diabetes and you are between the ages of 40-75.

3. If you LDL is above 190 (right now we push the drugs on people to get them down to 100 or lower).

4. If you’re between the ages of 40-75, and you have a higher risk of heart disease. How do you know that? Well, you use this formula: my.americanheart.org/…/Prevention-Guidelines_UCM_457698_SubHomePage.jsp

Frankly, in theory, it all makes some sense. You treat the patient, not the numbers. You’re supposed to emphasize lifestyle changes such as diet and exercise. Yet…

There is cost to consider. There are side effects to consider, such as a higher risk of diabetes from statin drugs, as well as the development of muscle pain. Plus, a lot … and I mean a lot of doctors aren’t 100 percent on board with this new thinking.

The main concern is that you should treat the numbers more aggressively. And that the guidelines will let other people fall through the cracks of heart disease. And even others will be treated who really don’t need to be.

As for me, we will see. I counsel my patients already on diet, exercise, etc. And I do believe in the big picture and not simply numbers. Plus I know I’m supposed to treat everyone as an individual, not a “case based on some formula.”

But if I’m prescribing more drugs, am I really doing a good job? I’m still waiting to see that formula developed.

I give these new guidelines a “wait and see.” Some things need a little digesting.

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