New Guidelines May Widen Use of Statins
Recommendations focus on patient risk factors rather than cholesterol numbers, experts say
The committee also said matching patients with the appropriate level of statin therapy is more important than achieving any specific target number, as was common in the past.
For young adults, preventing high cholesterol in the first place can go a long way toward avoiding heart attacks and strokes, the committee added.
About one-third of adults at risk for a heart attack or stroke have not been diagnosed but could benefit from primary prevention -- including taking statins -- according to the report.
Doctors should use known risk factors -- such as age, cholesterol levels, blood pressure, smoking and diabetes -- to assess cardiovascular risk. "These are the strongest predictors of 10-year risk for cardiovascular disease," Dr. Donald Lloyd-Jones, a professor of preventive medicine at the Northwestern University Feinberg School of Medicine and co-chairman of the committee, said during the press conference.
Patients at risk of a heart attack or stroke within the next 10 years should get immediate drug therapy and be encouraged to change their lifestyle, Lloyd-Jones said.
On the other hand, those at lower risk of heart attack or stroke should be counseled to make lifestyle changes and probably do not need drug therapy, he said.
Reducing obesity also cuts heart-health risks, and the new guidelines may help doctors and their plus-sized patients devise an effective -- and perhaps lifesaving -- weight-loss plan.
What works best are lifestyle changes, not crash diets, the authors of the new guidelines said.
"Our recommendation is that doctors prescribe a diet to achieve reduced caloric intake as part of a comprehensive lifestyle intervention," guideline co-author Dr. Donna Ryan, a professor emeritus at Louisiana State University's Pennington Biomedical Research Center in Baton Rouge, said during the press conference. The diet should be tailored to patient preferences and any drugs they take, she said.
Diet, physical activity and face-to-face behavioral counseling combined can lead to "clinically meaningful health improvement," Ryan said. "These benefits begin with weight loss in the range of 3 percent to 5 percent." The most effective behavior programs include two to three meetings a month for six months or more, according to the report.