New Guidelines on Cholesterol Drugs
Say the word “cholesterol” and many people will sit up and take notice for good reasons. According to our Cardiology department, Cholesterol has been shown to increase the risks for cardiovascular diseases, such as heart attacks and strokes, and for this, statin is usually recommended.
But should you even be on statin in the first place?
Motivation for the Change
The American College of Cardiology and the American Heart Association have issued new guidelines regarding who should be taking statin. The guidelines are expected to get more people on the cholesterol-lowering drugs, aside from recommending new weight and lifestyle measures designed to reduce the risks for cardiovascular diseases and instructing doctors to focus more on overall risks instead of cholesterol numbers.
Of course, there was nothing wrong with the previous approach of cholesterol numbers. There was simply a shift in focus from getting the numbers to reducing the cardiovascular risks and, hence, adopting a healthy lifestyle. This starts with moderate exercise, weight management, and healthy diet as well as stress management.
Suitable Candidates for Statin
But a few things have not changed despite the new guidelines. Doctors will continue to prescribe statin for patients who have been definitively diagnosed with heart disease.
People who meet the following criteria should be on statin:
- With Type 2 diabetes
- With extremely high levels of LDL cholesterol
- In their middle-aged years
- With an estimated 10-year 7.5% or higher risk of cardiovascular problems, such as heart and blood vessel health issues, especially among men and women in the 40-75 age bracket
Your doctor will determine your risks for cardiovascular problems, which factors in your cholesterol numbers, blood pressure and the use of blood pressure medicines, age, and smoking and alcohol, habits. You will be exempted, in a manner of speaking, from the risk calculator when you already have heart disease.
Use of Risk Calculator
It must be emphasized, however, that the risk calculator is not perfect since it can only provide relative risk percentages based on established risk factors. Still, the risk calculator is a useful tool in determining which patient should be on statin as a way of managing risks for cardiovascular diseases.
Furthermore, doctors use the risk calculator along with their clinical judgment based on the patient’s history. You, as the patient, should not use the risk calculator on your own, much less as a basis to self-prescribe statin.
Percentage Reduction
Keep in mind, too, that your doctor will target a percentage reduction in your cholesterol levels instead of targeting a specific number. The change in focus means that your doctor will also implement a few changes in your statin dosage as well as in new recommendations for a healthy lifestyle.
Your level of risk will largely determine the target percentage reduction your doctor will aim for. Your doctor will also take into account the type of goal, whether it is medium-risk or aggressive-risk reduction.
For example, if you have high risks, then your doctor will aim to cut your cholesterol level in half. If you have medium risks, then a goal of 30-50 percent is sufficient.
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