The recommendations are a bit more conservative than those given by the American College of Cardiology and the American Heart Association, and some doctors wonder whether they should be more aggressive.
For people who have a slightly lower 7.5% to 10% risk of having a heart attack or stroke in the next 10 years, the latest guidance recommends that they talk to their doctor and then decide whether they should take a statin.
Because the risks are slightly lower with this group, the benefits are small, even if they are still effective. In this case, the patient should speak to their doctor to determine whether they need to take one, based on individual factors. According to the task force member, “there are other factors at the individual level that a healthcare professional and a patient can together decide what might be best for that patient because of the increased risk of stroke or first heart attack.” There are other ways to reduce it.” Dr. John Wong, Professor of Medicine at Tufts University. That includes things like diet and exercise.
For adults 76 and older, there wasn’t enough research to make a recommendation about taking statins for the first time.
The last time the USPSTF revised its statin guidelines was in 2016. Since then, there have been several new studies that have determined how effective statins are, Wong said.
The bottom line, Wong said, is that 40 years of science have shown that statins are safe and a good primary prevention that can reduce a person’s risk of developing or dying from heart problems.
To make these recommendations, the USPSTF reviewed 26 studies to compare the results of those who took statins and those who did not. The study included more than half a million patients.
“Statins were significantly associated with a reduced risk of all-cause mortality,” the study said. This was true for all demographics.
Based on these studies the risk of taking statins seemed to be small. In the past there was some concern that statins might increase a person’s risk for muscle problems or diabetes, but apart from one study that involved high-intensity statin therapy, on balance, these guidelines were used to create These latest studies didn’t show a real increase in any problems, experts said.
What other guidelines recommend
“Individuals at high baseline risk have a more complete benefit from the intervention than do low-risk populations. Were statins either risky or costly, such a tailored treatment strategy would be appropriate. However, statins are now available as generic drugs.” are available and are both safe and affordable,” wrote doctors at the University of Texas Southwestern Medical Center in Dallas in an editorial.
“Any medical decision needs to be made in an individual context and these guidelines give a roadmap of sorts. There can be many different routes to get where you want to go, but it is a roadmap, Fry said. “The difference between the guidelines is relatively small.”
For example, one area not touched on in the USPSTF guidelines is a person’s coronary calcium score. A heart scan can look for calcium in the coronary arteries. There is a connection between calcium and plaque. For a patient who is borderline between high or intermediate risk, that score can be used as another determining factor.
Other factors that are taken into account by the ACC/AHA guidelines that are not part of the USPSTF calculus, which doctors refer to as “risk-increasing” may also help make decisions about those borderline cases. For example, a 35-year-old man who has a family history of heart disease and high cholesterol would not be included in these guidelines but may be a good candidate for a statin, says Dr. Salim Virani, Medicine. According to the professor of, section of cardiovascular research at Baylor College of Medicine.
“While increased risk can increase a patient’s short-term, 10-year risk, or in some cases, their lifetime risk of having a cardiovascular event, those guidelines suggest that physicians should err on the side of early treatment, not something that occurs.” Considered the recommendations of the US Preventive Services Task Force,” Virani said. “But I want to stress that, even if physicians take and follow the more conservative US Preventive Service Task Force recommendations, very aggressively, we will certainly see a population-level impact due to statin therapy.” . It’s actually been studied. for a very long time and now we know it works.”
University Hospitals Harrington Heart and Vascular Institute cardiologist and director of the UH Center for Cardiovascular Prevention, Dr. Ian Neeland, who did not act on any of the guidelines, said the USPSTF’s other big takeaway is a “reaffirmation” of their first. The guidelines and that the science they used clearly shows that statins are safe.
“Overall, the risk for serious, adverse events is very low and so the risk benefit will generally favor a statin for at-risk individuals,” Neiland said.
“Statins can be very helpful in long-term risk reduction and with very few side effects and great benefits. This is one of the major drugs that has changed the face of medicine,” Neiland said.
He also said that it is important to note that guidelines are only guidelines. “They need to be used in a clinical context and within the art and science of medicine,” Neiland said.
Virani said more would have to be done to prevent heart problems.
“We are definitely facing a huge wave of cardiovascular disease in our country and we really need to treat it with both lifestyle therapies as well as medicines,” Virani said.
what can patients do
Virani said it’s important for patients to ask their providers what their 10-year risk of having a heart attack or stroke is. This is a calculation that requires the knowledge of an expert and cannot be done by yourself.
“Having this conversation doesn’t mean you need to get treated, but it will also lead to a lot of important discussions about your lifestyle,” Virani said.
And statins, of course, aren’t the only way to help a person prevent a heart attack or stroke.
Both the USPSTF and the ACC/AHA recommend patients to stop smoking, be physically active, and eat a healthy diet to reduce their risk.
“Statins are one piece of the wheel of prevention. They are not the only piece,” Neiland said. “Diet, physical activity, maintaining a healthy weight, blood pressure control, making sure you control your risk of diabetes or diabetes. All those aspects play into heart health. Statin medication is one way to reduce risk.”
(This story has not been edited by seemayo staff and is published from a rss feed)