What do you all think about it? Do you feel like these studies are done in an unbiased way? I just don't feel like I can trust any study on statins, there is such a controversy surrounding them.
I was on them for 13 years due to family history of high cholesterol. I went off them to have a child and I have not gone back on them.
My type one grandfather has heart disease but he also smoked. He passed away in 1987 at a young age, Diabetes testing and control really sucked then. That is an understatement in itself.
Do I really need to worry about Heart Disease because I am type 1?
Has statin use dropped the countries number of deaths related to heart disease or stroke? Where is that study showing the drop?
http://www.cnn.com/2013/11/12/health/cholesterol-guidelines/index.html?sr=fb111213cholesterolmeds430p
Read it and tell me what you think about it all?
How many of you are on statins?
Copy of the news report.
(CNN) -- If you're not on medicine to lower your cholesterol yet, you might be soon.
In what's being called a tectonic shift in the way doctors will treat high cholesterol, the American Heart Association and the American College of Cardiology on Tuesday released new treatment guidelines calling for a focus on risk factors rather than just cholesterol levels.
The new guidelines could double the amount of people on medication to lower their cholesterol, experts say.
"This is an enormous
shift in policy as it relates to who should be treated for high levels
of cholesterol," said Dr. Steven Nissen, chief of cardiovascular
medicine at the Cleveland Clinic.
The biggest change from the old guidelines, he says: Ignore the numbers.
"For many years, the goal
was to get the 'bad' cholesterol levels -- or LDL levels -- below 100,"
Nissen said. "Those targets have been completely eliminated in the new
guidelines, and the threshold for treatment has been eliminated."
In their place, the
guidelines suggest using specific risk factors to determine who should
be treated with cholesterol-lowering statin drugs, and who should simply
make lifestyle changes.
Among the four questions
to ask to determine risks: Do you have heart disease? Do you have
diabetes (Type 1 or 2)? Do you have a bad cholesterol level more than
190? And is your 10-year risk of a heart attack greater than 7.5%?
According to the new guidelines, if you answered yes to any of those four questions, you should be on a statin. Period.
For those who do not fit
those criteria, the committee behind the new policy says lifestyle and
behavior management should be sufficient to help manage high
cholesterol.
"The focus for years has been on getting the LDL low," said Dr. Neil Stone, committee chairman.
"Our guidelines are not
against that. We're simply saying how you get the LDL low is important.
Considering all the possible treatments, we recommend a heart-healthy
lifestyle and statin therapy for the best chance of reducing your risk
of stroke or heart attack in the next 10 years."
Calculating risks
So how do you and your doctor determine if your 10-year risk of a heart attack is above 7.5% and you should be put on a statin?
A simple calculation, said Dr. Donald Lloyd-Jones, chairman of the committee that developed the equation.
"We were able to
generate very robust risk equations for both non-Hispanic white men and
women as well as African-American men and women," Lloyd-Jones said.
"Those equations factor in age, sex, race, total and HDL ('good')
cholesterol levels, blood pressure levels, blood pressure treatment
status as well as diabetes and current smoking status."
Each of those factors is assigned a numerical value and can be used to determine individual risk percentage using an online calculator.
The hope, Lloyd-Jones
said, is that by doing these calculations, patients can be more informed
about their risks when going to see doctors.
"The greatest strength
behind these guidelines is that they hit at the heart of prevention --
which is that lifestyle, rather than treating isolated risk factors, is
the key to reducing risk of chronic disease," said Dr. Sharon Horesh
Bergquist, an assistant professor of medicine at Emory University, in an
e-mail.
"We tend to focus on
'quick fix' answers such as a pill ... whereas the risk reduction from
lifestyle changes, such (as) exercise three-four days a week, reduces
risk nearly double to that from any one of the medication
interventions."
Double the prescriptions
By changing the way
doctors evaluate a patient for statin therapy, Nissen said these new
guidelines will effectively double the number of Americans eligible for
statin therapy, bringing the total to about 72 million.
So does this mean big
bucks for the pharmaceutical companies? Nissen said no -- and in fact,
it may mean a downturn in their business.
"Now, except for
Crestor, they're virtually all generic -- you can get a three-month
supply for $10," he said. "So there's really no money to be made with
statins anymore."
He goes on to say that
while prescriptions for these drugs will increase dramatically, the
guidelines all but shunned other cholesterol-lowering drugs such as
Zetia, a big moneymaker for Merck & Co.
Aside from the financial
aspects of medicating 35 million more Americans, using statins in a
much broader population has been controversial.
Some people, such as
cancer expert Dr. David Agus, advocate giving everyone older than 45 a
statin, due both to cholesterol-lowering properties and potential
benefit in reducing cancer.
Others say that with the
potential side effects from statin use -- muscle pains and soreness, a
potential moderate increase in liver disease and a risk for developing Type 2 diabetes -- they should be used with care.
Nissen, who strongly disagrees with Agus' suggestion on statins, said a measured approach is best.
"If you have a young
woman who is otherwise healthy, giving (her) a statin doesn't make any
sense at all," Nissen said. "I do believe the evidence is solid that if
you have risk, that statins are enormously beneficial."
Other recommendations
In addition to the
guidelines on evaluating cholesterol risk, the American Heart
Association and American College of Cardiology released two other sets
of guidelines relating to overall heart health.
One report gives
guidelines for eating a heart-healthy diet, including reducing saturated
and trans fats as well as limiting sodium to 2,400 milligrams per day
-- 30% less than the average American consumes on a daily basis.
The other report dealt
with treatment guidelines for physicians on managing weight loss in
their patients. They include a call to create individualized weight loss
plans and recommend counseling with a dietitian or other certified
weight loss professional for at least six months.
That report also goes on
to suggest that doctors should begin offering bariatric surgery as a
potentially viable option to improve health for patients with a body
mass index over 40, or those with a BMI over 35 and other complicating
factors.
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