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New US guidelines on statins raise concerns

WASHINGTON--Nearly every male and most women over 55 could fall under new U.S. guidelines for who should take cholesterol lowering drugs, researchers said Saturday, stirring fresh controversy in the medical world.

If applied to a group of 5,000 otherwise healthy people over that age in the Netherlands, 96 percent of men and two thirds of women could be prescribed some sort of statin, said the study in the Journal of the American Medical Association.

That is far more than would be allocated under European guidelines, raising new questions about how popular drugs like Lipitor (atorvastatin) and Zocor (simvastatin) are prescribed, why, and to whom.

Issued in November, the new U.S. guidelines call for more adults without heart disease to consider taking the medications in order to prevent future health problems — namely adults with a 7.5 percent or higher risk of a heart attack or stroke in the next 10 years.

In 2002, the federal guidelines said statins should only be taken by people if they had a higher than 20 percent risk of heart disease in the coming decade.

At a jam-packed session of the American College of Cardiology meeting Saturday, doctors insisted that America is not trying to “statinize” the world.

“No. This is conversation-starting material,” Sanjay Kaul, a leading cardiologist at Cedars-Sinai told a room full of colleagues as he and other panelists fielded questions about how to prescribe statins to patients at varying levels of risk.

“I think we need to remind ourselves we should not treat these as iron-clad rules. These are guides.”

Millions More Could Benefit

Statins can help prevent heart disease by lowering cholesterol in the blood and keeping the heart and arteries free of plaque buildup that can lead to stroke or heart attack.

Currently, some 25 million Americans take statins.

The new American Heart Association guidelines mean 56 million people in the United States may be candidates for the drug therapy, up from 43 million under the previous 2001 guidelines, according to research published earlier this month in the New England Journal of Medicine.

Kaul said this should not be a worrying trend, since the new guidelines align with evidence of the positive benefits.

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