New Cholesterol Drug Guidelines: Q&A
Q: If people start taking a statin, will they be expected to get their bad cholesterol to a certain number?
Rather than target a specific number, doctors will try to lower your cholesterol by a certain percentage, Dave says. How much your doctor expects you to lower your cholesterol will depend on your level of risk, he says, and whether the goal is aggressive- or medium-risk reduction.
If you are at high risk, the goal will be to cut the bad cholesterol by half. If you have some risk, your doctor may tell you to lower your cholesterol by 30% to 50%, he says.
Lowering cholesterol in this way helped people avoid heart attacks and strokes in the studies the experts looked at.
"We were much too focused on a number," Dave says. "Patients had to reach a certain number to determine success." Few patients did that, he says.
Q: Did the drug manufacturers have any role in this recommendation?
"None, actually," says Robert Eckel, MD, professor of medicine at the University of Colorado. He was a member of the cholesterol guidelines panel.
"People [on the panels] who felt they were conflicted did not vote on the guidelines," he says.
The expert panel looked at many studies to make its decision, the doctors say. For instance, studies showed that lowering bad cholesterol levels by 30% to 50% in patients at moderate risk could lower their chance of having a heart attack.
Q: Statins have side effects, including muscle aches. Can people try lifestyle changes first?
Living a healthy lifestyle is still important, the doctors agree. "Targeting a healthy lifestyle is the first step," Henry says, "then focusing on the use of statins for moderate- to high-risk patients.''
If your risk is very high, Dave says, your doctor may not give you time to try lifestyle changes by themselves. Instead, your doctor may prescribe medication as well as encourage you to improve your lifestyle.
And some people can't take statins, Henry says, because of side effects.