Statins recommended for some with no signs of cardiovascular disease
Health officials have broadened their recommendations for use of statin drugs to help prevent cardiovascular disease. The new guidance from the U.S. Preventive Service Task Force says adults ages 40 to 75 with no history of cardiovascular disease, but with a risk factor for the disease, should use a low- to moderate-dose statin.
There has been debate over whether statins are being overprescribed and whether side effects are being properly weighed.
Risk factors for cardiovascular disease include:
- Diabetes
- Hypertension, or high blood pressure
- Smoking
- Dyslipidemia, or an abnormal amount of lipids, such as cholesterol, in the blood
“People with no signs, symptoms, or history of cardiovascular disease can still be at risk for having a heart attack or stroke. Fortunately, statins can be a very effective way to help some people between 40 and 75 years old to reduce this risk,” said Task Force chair Kirsten Bibbins-Domingo, M.D.
However, statins might not be the answer in the face of unhealthy habits, the authors said.
“Regardless of your risks for heart disease, everyone can benefit from not smoking, eating healthy, exercising, and limiting alcohol use. Statins aren’t always the answer. Talk to your doctor about whether taking a statin to help prevent heart disease is right for you,” said Douglas K. Owens, M.D., a co-author of the recommendation.
The task force is commissioned by the government to review a range of health issues. It consists of independent experts whose recommendations influence Medicare coverage and private insurance guidelines.
Not everyone agrees
Some doctors expressed immediate concern over the new guidelines.
“It is worth taking a step back and asking why this debate is so contentious,” wrote Rita Redberg, M.D., and Mitchell Katz, M.D., in JAMA Internal Medicine. They call the use of statins for people with no symptoms of cardiovascular disease “a relatively weak intervention.”
They said people “at low risk have little chance of benefit but equal chance of harms and thus are more likely to have a net harm” from statins.
Side effects of the drugs include muscle pain and a higher risk of diabetes.
Redberg and Katz say the task force didn’t have access to enough primary data to make a confident recommendation about statin use. And they say business considerations are at play in the debate over the use of the drugs.
“One reason the debate is intense is because of the large market for statins if these drugs are recommended for primary prevention,” they wrote. “The global market for statins has been estimated to be a staggering $20 billion annually in the last decade. For that kind of investment, better data on risks and benefits should be required.”
What are statins?
Statins are a class of drug used to address low-density lipoprotein (LDL), often known as “bad cholesterol.” A high LDL is considered a risk factor for heart disease and stroke.
Statins lower LDL cholesterol by slowing down the liver’s production of the substance and increasing its ability to remove LDL that’s already in the blood.
Talk with your health care provider about whether a statin drug is right for you. You can find a Providence provider here.
To learn more
We’ve written previously about statins.
Here’s a report from the National Institutes of Health that foreshadowed the latest report: “Who to Treat with Statins.”
Here’s JAMA Internal Medicine’s Statin Issue, which discusses the task force recommendation, including an opinion piece critical of the recommendation (“Statins for Primary Prevention: The Debate is Intense, but the Data Are Weak.”)
Here is the recommendation by the U.S. Preventive Services Task Force.