NEW CHOLESTEROL GUIDELINES REDUCE HEART ATTACKS
Study from UT
Southwestern researchers found that recently introduced cholesterol guidelines
would significantly reduce new cardiovascular events, when compared to
treatment based on previous cholesterol guidelines.
The research
identified Dallas Heart Study participants in the 30 to 65 age range who would
have newly qualified for statin use under the new cholesterol guidelines
introduced in 2013 by the American College of Cardiology (ACC) and the American
Heart Association (AHA).
In this subset of
patients, the study predicted that 3.6 to 4.9 cardiovascular events would have
been prevented for every 1,000 people screened and treated according to the new
guidelines rather than the old guidelines (using a risk-reduction factor of 30
percent to 45 percent, depending on the statin dosage). The Dallas Heart Study
is a multiethnic, population-based study of thousands of Dallas County adults
whose cardiovascular health has been followed for 10 years.
Projecting these
findings onto the larger Dallas County population, about 4,500 serious heart
problems would have been prevented in individuals 30 to 65 years of age over a
10-year period by following the new cholesterol guidelines.
When the new
guidelines were introduced -- replacing previous guidelines from the National
Cholesterol Education Program/Third Adult Treatment Panel -- they provoked
heated debate over the sizeable increase in statin eligibility. However, the UT
Southwestern study supports the merit of the new cholesterol guidelines, as
well as increased statin use.
"This is one of
the first studies to carefully predict the implications of the new guidelines in
the general population beyond just the amount of increase in statin use,"
said Dr. Amit Khera, Associate Professor of Internal Medicine and Director of
the Preventive Cardiology Program at UT Southwestern. "Does it look like
these new guidelines will prevent heart attacks and strokes? The answer is,
'yes,'" he said.
Dr. Khera is senior
author of the recently published study, which appeared inCirculation:
Cardiovascular Quality and Outcomes.
The 2013 ACC/AHA
Cholesterol Guidelines recommend statins for patients with existing
atherosclerotic cardiovascular disease, type 2 diabetes, and very high levels
of LDL cholesterol, as well as for patients with a high 10-year risk for heart
disease.
The previous
guidelines from the National Cholesterol Education Program/Third Adult
Treatment Panel were based on a different formula that involved targeting
specific cholesterol levels. Some patients fall out of statin eligibility under
the new guidelines, but some 12.8 million more are newly eligible.
Among Dallas Heart Study
participants who actually experienced a cardiovascular event, 37.1 percent more
of those patients would have been placed on statins if the new guidelines had
been in place. Among participants who did not experience a cardiovascular
event, only 3.9 percent more patients would have been prescribed statins.
"There has been a
lot of emphasis on the increased use of statins and a lot of emphasis on the
risk calculator," said Dr. Khera, who holds the Dallas Heart Ball Chair in
Hypertension and Heart Disease. "Yes, there is some additional statin use,
but according to our results, this use seems appropriate, at least in this age
group."
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