Considering revised guidelines for cholesterol, statin, heart protection therapy and primary prevention…

With the new ACC/ASCVD guidelines for statin therapy, a cutoff of 7.5% risk for CV events was used to recommend treatment.  This has been controversial because it in essence comes close to recommending that we “put statins in the drinking water”, capturing over 90% of people age 65-75 that would be potentially statin therapy candidates.  This has raised concern for “overtreatment” and in talking with individual patients, they are not ready for “statin in the drinking water”.

A new analysis from JACC (link below) has given some more practical recommendations.  While any cutoff for therapy is arbitrary, the JACC suggestions do seem more workable.  As always, any decision for statin therapy is ultimately an individual decision between patient and care team.  The JACC article recognizes this also…

What are these new considerations?  Ages 40-55 lowered to a  5% cutoff, ages 66-75 women 10% and men 15% cutoff.  The abstract does not state specifically but the assumption is that age 56-65 would continue to use the 7.5% cutoff.


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