Dr. Steven Nissen, chief of cardiovascular medicine at the Cleveland Clinic described the radical change in approach to heart disease as “an enormous shift in policy as it relates to who should be treated for high levels of cholesterol.”
The bottom line is that the new guidelines abandon total cholesterol above 180 or a single minded focus to reduce LDL (“bad” cholesterol) below 100 as a justification for statins. Instead, risk factors will be used to assess heart disease risk instead of static numbers from a blood test.
The way the risk factors are to be assessed is via the four following questions:
- Do you have heart disease?
- Do you have diabetes (Type 1 or 2)?
- Do you an LDL above 190?
- Is your 10 year risk for heart disease greater than 7.5%?
If you answer “yes” to even one of the questions above, conventional doctors will now push for you to be on statins – most likely permanently.
Dr. Neil Stone, chairman for the committee responsible for the new guidelines, said that LDL will still be important, but no longer the focus:
Our guidelines are not against that. We’re simply saying how you get the LDL low is important. Considering all the possible treatments, we recommend a heart-healthy lifestyle and statin therapy for the best chance of reducing your risk of stroke or heart attack in the next 10 years.
Calculating Heart Disease Risk
How is a 10 year heart disease risk calculated?
According to Dr. Donald Lloyd-Jones, risk equations for non-Hispanic white men and women and African-American men and women have been developed that factor in age, sex, race, total and HDL (‘good’) cholesterol levels, blood pressure levels, blood pressure treatment status along with diabetes and current smoking status.
An individual’s risk assessment under the new guidelines can be determined using this online calculator.
Experts Insist New Guidelines Are About Saving Lives Not Making Money
Dr. Nissen of the Cleveland Clinic said the new guidelines which focus on a group of risk factors instead of just cholesterol will effectively double the number of people on statins, from 37 million today to 72 million.
Yet, he insists that the pharmaceutical industry has no money to make from the new guidelines. He even went on to say that it may cause a “downturn” in their business!
“Now, except for Crestor, they’re virtually all generic — you can get a three-month supply for $10. So there’s really no money to be made with statins anymore.”
It seems that Dr. Nissen is forgetting a very important point: what an individual pays for a prescription does not represent the total revenue earned by the pharmaceutical industry. Health insurance companies and the government pay and/or subsidize these drugs as well.
Remember the “free” H1N1 flu shots a few years back? “Free” to the consumer does not mean the pharmaceutical industry has donated the medicine out of the goodness of the stockholders’ hearts. Rather, it just means the government forked out millions instead with the consumer indirectly footing the bill.
Even if $10 did accurately represent the total cost for a 3 month supply of statins per person, $10 multiplied by 35 million is $350 million – and that would be earned 4x per year boosting pharmaceutical industry revenue by 1.4 BILLION dollars every single year.
That ain’t chump change my friends!
Risk Factors Still Portray Cholesterol as a Villain of Health
While focusing on risk factors rather than numbers on a piece of paper is a step in the right direction, the overall strategy for assessing cardiovascular risk still inaccurately portrays cholesterol as a villain.
The truth is that people with high cholesterol are not necessarily more likely to have a heart attack. While men who are young or middle aged have a slightly greater risk for heart attack if their total cholesterol level is over 300, for elderly women and men, high cholesterol is associated with a longer life. In addition, cholesterol levels just below 300 carry no greater risk than very low cholesterol levels.
In addition, the science does not indicate that cholesterol-lowering drugs save lives. Statins do not result in any improvement in outcome in recent trials involving thousands of test subjects. Why risk the devastating side effects of statins like cancer, muscle wasting and significant mental decline when they don’t help anyway? (source)
Opting out of the statin madness is still undeniably the best policy even with implementation of these new and “improved” guidelines.
Sarah, The Healthy Home Economist