The American College of Cardiology and the American Heart Association released a new guideline for treating blood cholesterol. The guideline is especially relevant to those at risk of heart disease from atherosclerosis (a hardening of the arteries).
The association pinpointed four groups that could most benefit from cholesterol-lowering HMG-CoA reductase inhibitors, or statins, an American Heart Association news release reported. The guidelines also work to encourage a heart-healthy lifestyle.
"The new guideline uses the highest quality scientific evidence to focus treatment of blood cholesterol on those likely to benefit most," Neil J. Stone, MD, Bonow professor of medicine at Northwestern University Feinberg School of Medicine and chair of the expert panel that wrote the new guideline. "This guideline represents a departure from previous guidelines because it doesn't focus on specific target levels of low-density lipoprotein cholesterol, commonly known as LDL, or 'bad cholesterol,' although the definition of optimal LDL cholesterol has not changed. Instead, it focuses on defining groups for whom LDL lowering is proven to be most beneficial."
The new guidelines recommend moderate or high-intensity statin therapy for patients that have cardiovascular disease, people with "bad" choleserol (190 mg/dL or higher), those with type 2 diabetes that are between the ages of 40 and 75, and "Patients with an estimated 10-year risk of cardiovascular disease of 7.5 percent or higher who are between 40 and 75 years of age (the report provides formulas for calculating 10-year risk)."
Risk assessment tools will allow medical experts to determine if patients would greatly benefit from statin therapy or if they need only focus on their cholesterol levels.
"The likely impact of the recommendations is that more people who would benefit from statins are going to be on them, while fewer people who wouldn't benefit from statins are going to be on them,"Stone said. Doctors may also consider switching some patients to a higher dose of statins to derive greater benefit as a result of the new guidelines.
The panel conducted a series of trials, and determined statins to be the best weapon in the fight against cardiovascular disease.
"Statins were chosen because their use has resulted in the greatest benefit and the lowest rates of safety issues. No other cholesterol-lowering drug is as effective as statins," Stone said.
The panel also found a heart-healthy lifestyle could make a huge difference in high-risk patients.
"The cornerstone of all guidelines dealing with cholesterol is a healthy lifestyle," Stone said. "That is particularly important in the young, because preventing high cholesterol later in life is the first and best thing someone can do to remain heart-healthy. On the other hand, if someone already has atherosclerosis, lifestyle changes alone are not likely to be enough to prevent heart attack, stroke, and death, and statin therapy will be necessary."
The panel recommends high-intensity stain therapy combined with a healthy lifestyle for people that fall into the four categories, as opposed to other methods such as combinations of drugs. The panel also said some who do not fall into the outlined categories could also benefit from statin therapy.
"The cornerstone of all guidelines dealing with cholesterol is a healthy lifestyle," Stone said. "That is particularly important in the young, because preventing high cholesterol later in life is the first and best thing someone can do to remain heart-healthy. On the other hand, if someone already has atherosclerosis, lifestyle changes alone are not likely to be enough to prevent heart attack, stroke, and death, and statin therapy will be necessary."
