Utah cardiologist weighs in on new cholesterol guidelines
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MURRAY — Just because new guidelines urge wider use of cholesterol-lowering drugs doesn't mean everyone can benefit from taking the popular class of statin medications.
In fact, adopting a healthier lifestyle and staying off the drugs altogether is the goal, according to one prominent Utah cardiologist.
"Patients at lower risk, the cost of the medications and potential side effects may outweigh the benefits of taking them," said Dr. Jeffrey Anderson, director of research at the Intermountain Medical Center Heart Institute. He said the drugs are useful if they can prevent further disease or incident.
Anderson is chairman of the task force of the American Heart Association and American College of Cardiology that was asked by the National Institutes of Health to develop the new recommendations on the matter. He said the updated guidelines, issued Wednesday, are "long overdue."
The new rules, Anderson said, signal a much-needed change in focus, leaning more on heart attack and stroke prevention measures than on managing cholesterol levels, as has been past common practice.
"As an organization, we have a goal of a 20 percent reduction in heart disease and stroke by 2020," he said, adding that the guidelines allow not only for better treatment, "but we can make people healthier and prevent it altogether."
The guidelines indicate statin use is appropriate for four groups of people, including individuals who already have heart disease or have had a stroke or related peripheral artery disease; those with diabetes; people with high cholesterol; and individuals with a risk factor for heart disease that is higher than 7.5 percent, determined by a new calculation that assesses a person's overall health.
Also of importance is incorporating an active and healthy lifestyle, including a heart-healthy diet that is low in sodium and full of fruits, vegetables, high-fiber cereals and grains, healthy fats and oils but low in saturated fats, and appropriate portion sizes, Anderson said.
Blood pressure management, he said, is also important but was not included in the formal guidelines.
"Know your numbers. That's the message to patients and the general public," Anderson said. "Find out what your risk is."
The research on cholesterol, he said, is firm. It has the potential to build up in the arteries and form plaque, blocking regular healthy blood flow. Factors that increase cholesterol buildup include high blood pressure, smoking, obesity and diabetes, and genetics.
"If that blocks off, it causes a heart attack that can cause heart failure or even death," Anderson said. "It is the most common cause of death and disability in adult Americans. It should be taken very seriously."
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