The new cholesterol guidelines released in November 2013 have identified four major primary- and secondary-prevention patient treatment groups who should be treated with statins. As referenced in a related examiner article, “if implemented by the medical community, this could result in millions of individuals now being placed on statin drug therapy, who previously would not have been considered for statin drug therapy.
These 4 treatment groups as outlined in the guidelines include:
- “Individuals with clinical atherosclerotic cardiovascular disease.
- Individuals with LDL-cholesterol levels >190 mg/dL, such as those with familial hypercholesterolemia.
- Individuals with diabetes aged 40 to 75 years old with LDL-cholesterol levels between 70 and 189 mg/dL and without evidence of atherosclerotic cardiovascular disease.
- Individuals without evidence of cardiovascular disease or diabetes but who have LDL-cholesterol levels between 70 and 189 mg/dL and a 10-year risk of atherosclerotic cardiovascular disease >7.5%.”
More specifically, your medical care provider may be prescribing statins if you fall into any of these categories specified in the guidelines;
- atherosclerotic cardiovascular disease – “high-intensity statin therapy … such as rosuvastatin (Crestor, AstraZeneca) 20 to 40 mg or atorvastatin 80 mg …should be used to achieve at least a 50% reduction in LDL cholesterol”
- if “otherwise contraindicated or when statin-associated adverse events are present, doctors should use a moderate-intensity statin.”
- “For those with LDL cholesterol levels >190 mg/dL, a high-intensity statin should be used with the goal of achieving at least a 50% reduction in LDL-cholesterol levels.
- “For those with diabetes aged 40 to 75 years of age, a moderate-intensity statin, defined as a drug that lowers LDL cholesterol 30% to 49%, should be used”
- “A high-intensity statin is a reasonable choice if the patient also has a 10-year risk of atherosclerotic cardiovascular disease exceeding 7.5%.”
- For the individual aged 40 to 75 years without cardiovascular disease or diabetes but who has a 10-year risk of clinical events >7.5% and an LDL-cholesterol level anywhere from 70 to 189 mg/dL, the panel recommends treatment with a moderate or high-intensity statin.
Previous guidelines were widely accepted; however, the new guidelines have already been challenged, with some arguing that specific components of the recommendations are not evidence-based. Nevertheless, the new recommendations may still have a major effect on the how various blood lipids are managed by care givers.
The 2013 cholesterol guidelines are just that … guidelines. Healthcare providers will make the final decision as to whether or not they will follow the guidelines in the treatment of high cholesterol or more specifically elevated LDL’s (bad cholesterol). Many of these providers have been practicing for decades monitoring LDL and other cholesterol components including triglyceride blood values in the management of cardiovascular and stroke risk factors. They may not be too quick to adopt the new standards or their patients quite yet.
Click here for additional reading; “Global risk assessment tool could place millions on statin therapy."
This information is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical/nutritional/fitness advice. Information presented is subject to change as additional discoveries are made or additional research is published.
Additional information: http://www.cardiosource.org/
Sources: http://content.onlinejacc.org/, http://www.nytimes.com/, http://circ.ahajournals.org/, https://www.lipid.org/, http://www.jaccjournaloftheacc.com/inpress/, http://en.wikipedia.org/wiki/, http://www.sciencebasedmedicine.org/new-cholesterol-guidelines/, http://www.cardiosource.org/News-Media/Publications/Cardiology-Magazine/2013/11/New-Risk-Assessment-and-Cholesterol-Guidelines-Spark-Debate.aspx; http://www.medscape.com/viewarticle/814152, http://en.wikipedia.org/wiki/NHLB, http://my.clevelandclinic.org/default.aspx, http://www.webmd.com/cholesterol-management/ldl-cholesterol-the-bad-cholesterol; The Lancet. Comment published online November 19, 2013 http://dx.doi.org/10.1016/S0140-