New Guidelines May Widen Use of Statins
Recommendations focus on patient risk factors rather than cholesterol numbers, experts say
Nearly 155 million American adults are overweight or obese, which puts them at risk of heart attack, stroke, diabetes and early death. Weight loss will lower blood pressure, improve blood cholesterol levels and reduce the need for medication to manage heart health, Ryan said.
For Americans, heart disease is the leading cause of death.
The experts said doctors should use a patient's body-mass index (BMI) to assess whether a patient is obese or not. BMI is a measure of body fat based on height and weight; a BMI of 25 or more is overweight.
"BMI is a quick and easy first screening step," Ryan said. Calculating BMI at least once a year will help identify those at a higher risk of heart disease and stroke because of their weight, she added. Waist circumference is also an indicator of risk.
Weight-loss surgery, also called bariatric surgery, may be the right option for those who are severely obese (a BMI of 35 or higher), especially if they have two other cardiovascular risk factors, such as diabetes and high blood pressure.
This emphasis on obesity is critical, said Medina, who was not involved with the report.
The problem? "Most patients don't think they are overweight or obese even with a BMI above 40," he said.
Besides reducing obesity, the new guidelines emphasize the need to maintain safe cholesterol levels, eat a healthful diet and assess other risk factors for heart attack and stroke.
Healthy Diet and Exercise
A healthy diet -- not necessarily a low-calorie diet -- and exercise reduce the risk for cardiovascular disease by lowering blood pressure and cholesterol.
"Dietary patterns that are heart-healthy... include lots of fish, vegetables and whole grains, and limit saturated fats, trans fats and sodium," cholesterol committee co-chairman Dr. Robert Eckel, a professor of medicine at the University of Colorado Anschutz Medical Campus in Aurora, said during the press briefing.
A heart-healthy diet of 2,000 calories per day should include:
- Four or five servings of fruit daily,
- Four or five servings of vegetables daily,
- Six to eight servings of whole grains daily,
- Two or three servings of fat-free or low-fat dairy products daily,
- Six or fewer ounces of poultry or fish daily,
- Four or five servings of nuts, legumes and seeds a week,
- Two or three servings of healthy oils a day,
- Limited sweets and sugars.