Tens of millions of Americans currently use statin drugs. Doctors have based that on cholesterol levels and various lifestyle factors. However, the U.S. Preventive Services Task Force suggests age should also figure into the decision.
Dr. Carl Horton is a cardiologist with Texas Health Physicians Group.
New guidelines: “[The U.S. Preventive Services Task Force] essentially recommended that if patients are between 40 and 75, if they have (at least) one risk factor for atherosclerosis or heart disease, and they are at risk of 10 percent or higher over 10 years, that they should be placed on a statin. And that’s even been expanded to include those patients where their risk is considered 7.5 to 10 percent.”
What’s behind the percentages: "If we looked at the total number of cardiovascular deaths per year, these numbers begin to add up significantly over time. This is a very good, well-thought-out guideline, but it’s really on the prevention side. Most of the time [that] we talk about cardiovascular disease, we talk about the new innovations. But those innovations, a lot of time, treat people at the end stage of their disease. [There is] no focus on the prevention and that’s what been wrong with health care from the beginning. We know that are patients that can be helped with this guideline. It’s just kind of weighing the risk and the balance of the medication, as well as the potential benefit to the patient.”
Why not start statins for people 76 or older: "Patients in the age range are still being treated with statin therapy if they’ve had events, myocardial infarction or have underlying coronary heart disease, strokes. They are still being treated in that range. But we can’t necessarily recommend it for primary prevention in that range because we just don’t have the data.”
Are statins over-prescribed? "I think in some cases they may be over-prescribed, but that’s not very often. I think if you look at the American diet, if you look at risk factors for atherosclerosis, in most cases I think statins are prescribed appropriately."
To avoid medication: “You have to be very aggressive with your dietary restriction, and also exercise. You have do those things that are going to be beneficial to your body long term.”