New guidelines would exclude more than 9 million Americans
Heart health often feels like something only those “at risk” have to worry about. But who exactly is considered at risk depends on which heart health guidelines your doctor is following, according to a new study in JAMA.
In 2013, the American College of Cardiology and American Heart Association (ACC/AHA) released their recommendations for statin therapy, a cholesterol-lowering preventive treatment for heart disease. The guidelines substantially increased the pool of people who would be eligible to take the drugs.
Then in 2016, the U.S. Preventive Services Task Force (USPSTF) released their own set of recommendations, which upped the risk threshold for cardiovascular disease and required that a patient have at least one existing risk factor (like hypertension or diabetes) in order to qualify for the preventive heart health therapy. In other words, it raised the bar for which risk factors were serious enough for concern.
But is that a good thing? After analyzing the two groups covered by each set of guidelines, the researchers in JAMA concluded that a lot of young adults with high longterm risk of heart issues may be excluded from getting preventive meds—even though they still have some serious long-term risk factors.
Here’s how the numbers break down between the two sets: Under the 2016 guidelines, about 17.1 million adults should start taking statins (on top of those already on the meds). But if doctors stick to the 2013 ACC/AHA recommendations, 26.4 million U.S. adults should start taking statins—that's a difference of about 9.3 million people. So put another way, the 2013 guidelines covered about 24 percent more people.
Among those included in the 2013 at risk group but not the 2016 guidelines, 55 percent are adults ages 40 to 59 years with an average risk of heart issues over 30 years greater than 30 percent, and 28 percent have diabetes. Both of these factors can signal high risk for heart issues.
So the jury is still out on what constitutes high enough risk to start taking statins as preventive therapy. Until a greater medical consensus can be reached, your best bet is to talk to your doctor about what works for your particular situation. And in the meantime, be sure to take advantage of med-free ways to keep your heart healthy, like through regular exercise and a heart-healthy diet.