Nearly 40 million could benefit from cholesterol-lowering statins
Last year, the U.S. National Institutes of Health (NIH) revised its guidelines for preventing heart disease. One result was that the number of people who can benefit from taking cholesterol-lowering statin drugs nearly tripled.
Several studies have found that reducing the level of low-density lipoprotein or LDL can reduce the short-term risk of heart disease by as much as 40 percent. Statin drugs are considered an effective and relatively safe means of helping achieve this reduction.
Under the old guidelines, 13 million Americans were targets for cholesterol-lowering drugs; under the new guidelines, that number rose to 36 million, meaning far more people should be able to use them to decrease their risk for heart disease.
ABCNews reported that the new targets for cholesterol are much lower than they were. The new goal is to get your LDL, or "bad" cholesterol level, below 100. The old recommendation was 130. These are the strictest guidelines, set for people with many risk factors.
One of the independent risk factors listed in the report is diabetes; the NIH guidelines say that having diabetes is as important a risk factor as having heart disease itself. You're also at higher risk for heart disease if you smoke, have high blood pressure, are older, or if you have a family history of heart disease.
Women shouldn't rely on estrogen
Another key finding in the guidelines is that women shouldn't rely on estrogen for heart protection. Many older women have been told that hormone replacement therapy will protect them from getting heart disease. But many questions have been raised about the safety of that treatment, and doctors have also learned that the therapy doesn't really do what it's supposed to do.
This report says women should not rely on estrogen for heart protection. They should take statins, instead.
Strict dietary guidelines
The report also has stricter eating guidelines, with more stringent limits on the amount of saturated fat people should consume. It recommends no more than 35 percent of calories from fat and only 7 percent from saturated fat.
Take drugs earlier
Possibly the most significant recommendation: Use drugs sooner, rather than later. The prevailing wisdom used to be, try diet and exercise, and only if that doesn't work, move to medication. Now, the experts are saying start with the drugs right away.
Statin drugs approved for this purpose include Mevacor, Pravachol, Zocor, Lescol and Lipitor. Another, Baycol, was removed from the market by drug maker Bayer after considerable negative publicity about a rare side effect. The drugs are considered to be remarkably safe, but doctors have found that a very small number of patients will have temporary liver problems. So, doctors monitor the liver with simple blood tests, switching to another medication if there's a problem.
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Posted: April 2002
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