The US Preventative Services Task Force (USPSTF) has released its final guidelines regarding use of statins in the general population and published these in the Journal of the American Medical Association. They recommend anyone between the age of 40-75 who have at least one risk factor for heart disease, (putting them at a 10 percent or greater risk of having a heart attack or stroke in the next 10 years) be prescribed a statin.
What are statins?
Statins are a class of cholesterol lowering agents that work by inhibiting the enzyme, HMG-CoA reductase, that slows down the production of cholesterol. Statins come in many brands such as Lipitor, Crestor, Pravachol, Zocor, etc and have “statin” in their generic name (atorvastatin, simvastatin, etc.). They are one of the most popular medications to treat high cholesterol and are included in the drug cocktail given to anyone who suffers from arteriosclerosis. They lower total and bad cholesterol significantly and can prevent heart attack.
What are risk factors for heart disease?
These include any of the following:
Male over 40
Female over 55 – post menopausal
High Blood Pressure
Family history of heart disease
Personal history of heart disease
History of preeclampsia during pregnancy
and many others such as lack of exercise, obesity, stress, short stature, and poor hygiene
…..so as you see, so many of us can easily fall under this group of “at risk”
What are the risks of statins?
These medications work by decreasing cholesterol production in the liver and muscles, so side effects could include these areas.
Elevated liver enzymes – rarely leading to liver failure
Rhabdomyolisis – inflamed muscle – rarely leading to renal failure
interference with the metabolism of other medications
possible increased risk of diabetes (currently being studied)
Despite the risks (that occur very rarely), many medical professionals have been very pleased with statin’s success in improving cardiac status. I believe this guideline recommendation from the USPSTF will most likely meet little resistance from the medical community. It will however take more work on the side of the patient as they need to follow up with their medical provider more often so as to be monitored closely for its efficacy and side effects.
For more information on the USPSTF recommendations click here: http://jamanetwork.com/journals/jama/fullarticle/2584058
Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician