Should everyone be on cholesterol medicine?


“If you’re not on medicine to lower your cholesterol yet, you might be soon,” says Matt Sloane of CNN in a recent article regarding some new cholesterol treatment guidelines released by the American Heart Association and the American College of Cardiology.

The recently released guidelines are set to change the way high-cholesterol individuals are treated and could nearly double the amount of those on cholesterol medications.

What does this mean for both those already on statin medications and those who might be at risk for high cholesterol in the future?

Dr. Jeffrey Schussler, MD, interventional cardiologist on the medical staff at Baylor Heart and Vascular Hospital in Dallas broke down this new research and answered some common questions.

What’s behind the research and new guidelines?

New guidelines were released trying to determine who needs to be on statins and who doesn’t need to be. We used to be told that people with diabetes needed to be on statins because they are high-risk individuals. We’ve known for a long time that they’ve needed to be on the medicine.

But the recent guidelines suggest that if you are a diabetic, regardless of your cholesterol numbers, you need to be on the medicine.

What do you mean regardless of your cholesterol numbers?

The biggest “win” isn’t getting your cholesterol down to a certain level, the biggest win is keeping you from having a heart attack. So therefore numbers aren’t the most important thing to take note of because statins can help reduce the numbers and risk for events.

The article referenced the importance of determining your “10-year heart attack risk” and checking to see if it is over 7.5 percent. Could you break this down?

There are a lot of calculators available online that are based on studies that involve plugging in age, sex, blood pressure, diabetes, whether or not you are a smoker, and more. They then take that data and compare it to population data, which gives you a rough estimate of your 10-year heart attack risk.

These are just estimations and aren’t foolproof.

The article suggests that statins should be more widely prescribed. Does that mean most people should be on statins?

Not necessarily. The biggest problem is treating people for primary prevention, meaning before you actually have a problem. It’s hard to predict the future and determine who would have a heart attack down the line or be on statins in the future.

Generally speaking, statins are safe and effective.

Finding the right people to treat is the trick. If you’ve had a heart attack or heart stents, then you are considered high risk. That means that you need to be on cholesterol medicines.

If you have someone who is 30-years old, non-hypertension and is a non-smoker, they’d seem low risk. But if every man in that family had a heart attack, they are still at high risk and should be on medication.

How do we know that statins are safe?

We have data from millions of patients over years that shows statins are incredibly safe, maybe even safer than aspirin. 

What are the main takeaways from these new guidelines?

If there’s a good enough reason to be on treatment, the drawbacks of treatment are very low. Cholesterol medicines are cheap, effective and safe, so because of this there should be a low bar to treat everyone at risk.

If I told you that there was a vitamin that you could take that was safe, inexpensive and could lower your heart attack risk, you’d buy it in a heart beat.

There is, it’s a medication that is far less expensive and more effective than fish oil, Omega 3 supplements and aspirin. None of the vitamins and supplements reduces cardiovascular or cancer risk. Period.

About the author

Garyn Goldston
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Garyn is a proud TCU Horned Frog and a rowdy Dallas-Fort Worth sports fan. He is a former physician liaison for Baylor Jack and Jane Hamilton Heart and Vascular Hospital.

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Should everyone be on cholesterol medicine?