Statin-nation; Are these new guidelines designed to promote low cholesterol or double the usage of statin cholesterol meds?
This past Wednesday, the NJ Star Ledger reported that the “Push is on to put more U.S. adults on statins. If you have been reading this blog for a while, you have an understanding of how dangerous Statins are. Drug marketers are very shrewd, especially since the regulatory authorities, the American Heart Assn. and the American College of Cardiology with of course the advice and money of big pharma are all in on the idea that more of us need to buy their products, visit our doctors more and take drugs that potentially can damage our muscles, livers and create diseases we wound otherwise never experience on our own.
Sales of Lipitor slow, so what so what do you do when you are a large drug company concerned about a trend they have influence over; you come up with newer guidelines that put more people in the viewfinder of the average doctor.
As a healthcare consumer, you need to realize that cholesterol is but one of the 18 risk factors for cardiac disease, yet the attention given this one risk factor is out of line with the overall risk which is largely affected by inflammation in the body. Also, many people have genetics that handle cholesterol well without having to take anything. Does this one size fits all solution make sense.
Dr. Charschan’s advice, think carefully before blindly following the crowd on this one. I really doubt the evidence regarding cardiac disease warrants this level of intervention. Great use of these medicines does not necessarily mean you will live longer, and in fact, is likely to guarantee that you may experience other problems such as muscle pain and possible liver issues, while it also guarantees you will be visiting your doctor more frequently, as these medications require careful monitoring by your doctor.
Forbes weighs in with their opinion.
Should You Now Start Taking Statins?
The main philosophical shift in the guidelines is the lessened importance of LDL levels in prescribing statins to prevent heart attacks and stroke, instead of seeing it as just one factor among many. “It’s really about your global risk,” committee member Donald Lloyd-Jones, chair of the Department of Preventive Medicine at Northwestern University, told The Washington Post. “There were a number of people at substantial risk who, under the old paradigm, were not being captured.”
American College of Cardiology vice president Kim Williams told The Washington Post, “Lower [LDL] is better, and no one’s arguing that, but once you have a reason to treat someone, they should be treated fully. That’s really one of the bottom lines of this.”
Criticism From Several Fronts
Other experts in cardiovascular disease prevention have already come forward to question the committee’s decisions on medical and psychological fronts. Some claim the new standards are too conservative. Relying on a 10-year risk of heart attack or stroke, they contend, may ignore many younger people with high cholesterol but a low risk of cardiovascular event due to their age. Such younger adults could benefit from LDL-lowering statins before their levels put them in a high-risk group.
And many doctors worry that by lessening the importance of target LDL levels, many patients and doctors will become lax about pursuing lifestyle changes. Dr. Daniel Rader, director of the preventive cardiovascular medicine and lipid clinic at the University of Pennsylvania, was initially on the committee writing the guidelines but left because he did not approve of its direction. He told The New York Times that he and his colleagues suspect that many medical practices will ignore the new advice and continue to push patients to lower their LDL level to 70 through both medication and lifestyle changes.
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