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Some Doctors Challenge New Statin Guidelines

They say too many people would get the cholesterol-lowering drugs; heart groups defend the recommendations

WebMD News from HealthDay

Finding might reassure women considering the

By Dennis Thompson

HealthDay Reporter

MONDAY, Nov. 18, 2013 (HealthDay News) -- A new online cholesterol risk calculator produced by two leading U.S. heart organizations is flawed and overstates a person's risk of heart disease, a pair of Harvard Medical School professors say.

The professors contend that this flaw could lead the calculator to mistakenly suggest that millions of people should be taking cholesterol-lowering statin drugs, The New York Times reported Monday.

Key officials with the American Heart Association (AHA) and the American College of Cardiology (ACC) stood by the calculator during a hastily gathered news conference Monday morning at the heart association's annual meeting in Dallas.

Harvard professors Dr. Paul Ridker and Dr. Nancy Cook reportedly pointed out problems with the calculator a year ago, saying that it did not seem to work accurately when they tested it using patient data, the Times reported.

When the online calculator went live last week, Ridker and Cook again tested it and reported serious flaws that could overestimate a person's risk of heart disease by 75 percent to 150 percent, the newspaper reported. Their findings are to be published Tuesday in the medical journal The Lancet, according to the Times' report.

AHA and ACC officials said Monday that the Harvard professors' analysis of the calculator relied on patient data from three heart studies involving people both younger and healthier than the average American.

"These people exist in the U.S. population, but it's a very healthy, skewed group," said Dr. Donald Lloyd-Jones, chair of the department of preventive medicine at Northwestern University's Feinberg School of Medicine.

Lloyd-Jones said he and others met with Ridker on Saturday, as the AHA meeting got under way, and reviewed a limited amount of the Harvard doctors' data. He said he's still waiting to see the full report.

"I think all of us would like to see Dr. Ridker's data, and see that play out in scientific discussion rather than in the media," Lloyd-Jones said.

The two heart health groups said they created the calculator -- as well as a set of aggressive new cholesterol-lowering guidelines -- using a broad range of patient data that allowed them to incorporate factors that hadn't been included in previous risk assessments. For example, prior attempts did not include calculations for African-American populations, and did not attempt to include stroke risk.

"The truth is, the risk equations work exactly the way we asked them to," Lloyd-Jones said.

Officials from both heart groups added that just because the calculator suggests some people would benefit from statins doesn't mean they absolutely have to take them.

Instead, the calculator should prompt a conversation with their doctor about whether they need to take statins or undertake other lifestyle changes to lower their cholesterol.

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0-199
Borderline
200-239
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240+

Your level is currently

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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