Last
week, the American Heart Association released a sweeping new set of guidelines
for lowering cholesterol, along with an online calculator meant to help doctors
assess risks and treatment options.
Paul Ridker, MD, a cardiologist at Brigham and Women's Hospital (BWH) in Boston, strongly supports the key
messages of the new guidelines and believes that questions raised about the
risk calculator should be relatively easy to address. Dr. Ridker is an advocate
of expanded statin use in primary prevention, a major advance of the
new ACC/AHA guidelines.
"The new ACC/AHA guidelines for statin therapy
have taken several major steps forward that will greatly improve patient care.
These include an emphasis
on prevention of stroke as well as heart disease, a
focus on statin therapy rather than alternative unproven therapeutic agents,
and recognition that more intensive statin
treatment is superior to less intensive treatment for many patients.
Further, the new guidelines greatly simplify care for the general medicine
community. It is critical for patients
with known heart disease, diabetes, or high levels of LDL-cholesterol to be treated
and treated aggressively.
Our
patients need to go to the gym, throw out the cigarettes, and eat a healthier
diet, but in addition to lifestyle,
middle aged men and women need to talk to their physicians to see if they should
also be on statin therapy.
In the
arena of primary prevention, there are now six major randomized trials
demonstrating that statin therapy, in addition to lifestyle improvement,
substantially cuts rates of heart attack and stroke. From a public health
perspective, we need to make certain that prescribing physicians understand who
was treated in the trials, what the data show, and how to translate that
knowledge to best care for our patients."
