A panel of medical experts gathered by the federal government now officially recommends that a broad swath of the U.S. population over age 40 should take statin drugs. According to the U.S. Preventive Services Task Force recommendations released this week, Americans from 40 to 75 with at least one risk factor for cardiovascular disease and a 10% or higher risk of heart attack or stroke over the next decade should take statins.
Of note, people above 40 with a 7.5 to 10% risk of heart attack or stroke based on the American Heart Association and American College of Cardiology risk calculator (http://www.cvriskcalculator.com) should also consider taking statins.
More on new USPSTF recommendations for statins
“In addition to a healthy lifestyle, s tatins are useful for people at an elevated risk for cardiovascular disease,” said Dr. Douglas Owens, of Stanford University in California and a member of the USPSTF.
Keep in mind that risk factors for cardiovascular disease include high total cholesterol or triglycerides, high blood pressure, diabetes and smoking. The t10-year risk of heart attack and stroke is using these and other factors such as sex and ancestry.
According to data from various sources, heart disease, stroke and other cardiovascular diseases kill upwards of 800,000 people in the U.S. annually.
Cholesterol (a type of fat in the blood) builds up and forms a plaque in arteries and boosts the risk of heart attacks, strokes and other cardiovascular problems. Statins work to reduce cholesterol minimizing production in the liver.
The USPSTF is making a recommendation on the use of statins for the first time. The recommendation is based on an in-depth analysis of data from 18 randomized controlled trials comparing statin use in those without prior heart attacks and strokes to people taking placebo pills or no treatment.
Statins do reduce mortality
Donald Lloyd-Jones, MD,, a member of the USPSTF panel from Northwestern University noted: “There has been some debate in some quarters that we shouldn’t use statins for primary prevention because they don’t reduce total mortality,” he said. “That argument is dead because this is now the third systematic review in a row that showed statins reduce total mortality in addition to all the other things. If that’s your yardstick for something we should be doing in primary prevention, that has been met. That debate needs to end.”
Lipid screening also recommended
The USPSTF task force also recommended universal lipid screening for everyone 40 to 75 age range.
However, for younger and middle-aged adults, the task force did not find enough evidence for either screening or statin prescription. Of note, a separate report about children concluded that the evidence was inadequate to recommend for or against lipid screening.
“There is less data available for the pediatric and older populations. While absence of proof is not proof of absence, more data is clearly needed to make evidence-based recommendations,” pointed out ACC President Kim A. Williams Sr., MD, of Chicago’s Rush University Medical Center.
Both the National Heart, Lung, and Blood Institute and the American Academy of Pediatrics recommend screening adolescents and other high-risk groups for dyslipidemia (high cholesterol or triglycerides), but the suggestion has been criticized for the lack of supporting evidence.