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Are Statins Overprescribed? New Research Shakes Up Heart Health Guidelines

Daniel Kim Views  

According to a recent study’s new cardiovascular disease risk calculation, approximately 17 million American adults don’t have to take statins.

The research comparing the scale of the population eligible for statin therapy according to two types of atherosclerotic cardiovascular disease risk calculations was published in the Journal of the American Medical Association (JAMA) Internal Medicine.

According to the American Heart Association, atherosclerotic cardiovascular disease (ASCVD) is a condition that occurs when plaque accumulates in the artery walls, restricting blood flow. If blood flow to vital organs is confined, major organs get damaged and potentially lead to life-threatening conditions such as heart attacks and strokes.

High cholesterol levels increase the risk of atherosclerotic cardiovascular disease, and statins are used to lower these levels, which are typically prescribed after calculating the risk of atherosclerotic cardiovascular disease.

The Pooled Cohort Equation (PCE), developed by the American Heart Association in 2013, can determine the 10-year risk of atherosclerotic cardiovascular disease. However, a downside is that the cardiovascular disease probability of population groups not reflected in the study’s initial cohort may be inaccurate.

The American Heart Association’s Cardiovascular-Kidney-Metabolic Scientific Advisory Group developed a new formula called PREVENT in 2023 to explain this phenomenon, removing cases of kidney function, social deprivation index, statin usage, and race-related variables.

The researchers investigated the differences in the population eligible for statin therapy calculated by the Pooled Cohort Equation and the PREVENT formula, using data from the National Health and Nutrition Examination Survey (NHANES) of 3,785 American adults without atherosclerotic cardiovascular disease.

The population eligible for statin therapy was determined according to the 2019 American Heart Association (ACC/AHA) guidelines, which include adults aged 40-75 with diabetes, high cholesterol levels, and a 10-year atherosclerotic cardiovascular disease risk of 7.5% or more.

The study found that the participants’ 10-year risk of atherosclerotic cardiovascular disease was 8% using the Pooled Cohort Equation and 4.3% using the PREVENT formula.

The most significant differences were seen in black adults and seniors aged 70-75. For black adults, the risk was 10.9% using the Pooled Cohort Equation and 5.1% using the PREVENT formula. For seniors aged 70-75, the risk was 22.8% using the Pooled Cohort Equation and 10.2% using the PREVENT formula.

When calculating the subjects eligible for statin therapy according to the 2019 guidelines, the Pooled Cohort Equation suggested that 45.4 million American adults were eligible. Still, the PREVENT formula suggested only 28.3 million, implying low necessity in 17.1 million adults taking statins.

Based on these results, the researchers concluded that according to the new cardiovascular disease risk calculation, approximately 17 million American adults may not need statins.

Daniel Kim
content@viewusglobal.com

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