New recommendations were announced Tuesday by the American College of Cardiology and the American Heart Association. They say an estimated 31 percent of Americans could benefit from the use of statin drugs. That figure is more than double the current percentage (15 percent) of Americans taking these medications to lower their cholesterol. The recommendation, which is based on a four-year review of data, aims to simplify the multi-process evaluation for people who should be taking statins.
Oklahoma Heart Institute cardiologist Dr. Raj Chandwaney explains why these new recommendations will be helpful to patients, especially in Oklahoma. "It is estimated that an additional 33 million individuals in the U.S. should start taking statins as a result of the new guidelines," says Dr. Chandwaney. "This is great news, because cardiovascular disease is still the leading killer in the United States accounting for 1 out of every 3 deaths that occur. The problem is even worse if you focus on the state of Oklahoma, which has the 50th worst coronary heart disease death rate in the country. We are optimistic that expanding the role of these life saving statin drugs across a broader population will continue to reduce the burden of cardiovascular disease in our society."
Who should take statins?
Anyone who has diabetes, suffered a heart attack or who has LDL cholesterol levels in excess of 190 mg/dL are now advised to take statins (versus patients staying on statins to hit a target of 70 mg/dL). Additionally, anyone with a risk of 7.5 percent or greater of having a heart attack in the next 10 years is included in this new recommendation. To determine that risk, the American College of Cardiology and the American Heart Association developed this new risk factor calculator, which takes into account blood pressure, age, total cholesterol and stroke history. Under these new recommendations, more women and African-Americans are expected to qualify for statin therapy, if they have a higher-than-average risk of stroke.
Broader Recommendations to Reduce Heart Attacks and Strokes
While new statin use recommendations are the big story, it is only one component of the America College of Cardiology and the American Heart Association’s new guidelines to help prevent more heart attacks and stroke in the U.S. The first of a five-part article series posted on blog.heart.org also puts forth that providers define and treate obesity as a disease, use a new equation to assess African-American’s specific cardiovascular risk and recommend new dietary and exercise guidelines for patients.
Citing research that shows that more patients are successful at obtaining and maintaining a healthy body weight under the care of a health care provider, the article encourages providers to actively manage this process for patients. The new guidelines sets forth a plan for helping providers achieve this – first by requiring at least once a year a body mass index (BMI) for every American. Secondly, the new guidelines find patients can benefit from weight loss with only one other risk factor, as opposed to the old recommendation of two or more (such as hypertension, high cholesterol, family history).
Donna Ryan, M.D., co-chair of the committee who wrote the new guidelines, says in the article, “The key message here is that we know weight loss isn’t just about will power.” She adds, “It’s about behaviors around food and physical activity, and getting the help you need to change those behaviors.”
Another key component to the guidelines, as mentioned above, is the new risk assessment calculator. Since African-Americans are at an increased risk of heart attack and stroke, going off of the previous assessment build on long-term research of a white population, did not give accurate information to providers. By adding in new risk assessment for stroke, this new equation is beneficial for a larger audience as well – as it is based on more current research of a broader audience. The new risk assessment calculator is recommended for anyone 40 to 79 years old to assess his or her 10-year risk.
New dietary and exercise guidelines focus on maintaining overall heart-healthy behaviors, specifically designed to target people who need to lower cholesterol and blood pressure. That is still a pretty broad group of Americans – as one in three have uncontrolled high cholesterol and two in three have high blood pressure. Consuming less sodium through a step-down approach from 3600 milligrams daily to 2400 milligrams dailey to finally a target of 1500 to lower blood pressure. Exercising at least 40 minutes a day three to four times a week at a moderate to vigorous level is also recommended.