In November 2013, new guidelines were introduced by leading heart organizations concerning cholesterol levels. The guidelines focused on the use of the drug statin, which can help to reduce the risk of heart attacks and other serious cardiovascular problems. A recent report suggests that statin use may greatly increase, even in those without cardiovascular disease, under the new guidelines.
Statin is a type of medical drug that reduces the amount of cholesterol produced by the liver, resulting in lower levels in the blood. Cholesterol is believed to be one of the causes of heart attacks and strokes, and so taking the medicine may reduce the risk. It can be prescribed to a wide range of people, including those with very high cholesterol levels , diabetes, and a family history of heart attacks.
The new guidelines however, broaden the category of eligible users, allowing more highly available prescriptions of the drug. Under the new guidelines patients in the high risk category, those who have a heart attack, or at a very high risk through diabetes, will no longer be told to reduce their cholesterol by diet and exercise; instead they should adjust their dosage of the drug. A new risk calculator includes measures of age, blood pressure, and cholesterol levels, and strokes have become an addition, on top of heart attacks.
A report recently released in The New England Journal of Medicine examined the predicted future use of statin in 40-75 year olds under the new guidelines. The study analysed data from National Health and Nutrition Examination Surveys from 2005 to 2010. They summarized the risk factors and estimated the number of eligible patients. The findings estimate a great increase in usage, with the number eligible increasing from 43.2 million to 56 million, representing an increase of over 11 percent.
The findings of the research that could turn the most heads, is that the new guidelines may greatly increase the use of statins in those without cardiovascular disease. Of the 12.8 million increase, 10.4 million is expected to be in adults who do not suffer cardiovascular disease. The analysis also concluded that the drug would become more widely used in those who only have a small risk of future concern.
The report raises concerns over the level of prescription for the statins. It furthers already existing concerns about the validity of the drug in the first place. One of the reasons for using statin is to reduce cholesterol, which is assumed to be a key risk factor in heart attacks and other cardiovascular problems. Although the general medical consensus asserts the link, and the subsequent benefit of the use of statin, other research suggests otherwise.
A quick glance of research from the UK shows that high cholesterol decreased dramatically between 1994 and 2006, from 84 percent down to 54 percent in 65 to 74 year olds. During this period coronary heart disease did not drop with it, suggesting that the correlation may at least be exaggerated. The UK in general has a low-level of cholesterol, whilst having one of the highest rates of coronary events in the world.
Whether or not people who are at a low risk should take the drug is debatable. It may be available to more than just the people who need it. The new guidelines may be about to greatly increase the use of statin in those without cardiovascular disease. Despite this Michael Pencina, co-author of the report, estimates that over half a million cardiovascular events will be prevented over the course of the next 10 years.
By Matthew Warburton