Experts Warn New Cholesterol Calculator Doesn’t Add Up

The cholesterol calculator rolled out with the new guidelines for lowering cholesterol last week appears to overestimate risk of heart disease

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A new online calculator meant to measure cholesterol risk — rolled out just last week by the nation’s leading heart organizations along with new cholesterol-lowering guidelines — is so riddled with problems that leading cardiologists are calling for a halt in implementation to the new cholesterol-fighting strategy.

Last Tuesday, the American Heart Association and the American College of Cardiology unveiled a new strategy for battling heart disease, which called for doubling the number of Americans on statins, or cholesterol-lowering drugs. They also introduced an online calculator designed to help doctors assess risk of heart disease. But the calculator turns out to be flawed, overestimating cardiovascular risk, experts tell the New York Times. As the calculator is designed now, it could recommend statin drugs to millions of Americans who do not need them.

Two Harvard Medical School professors identified the problem in findings that will be published on Tuesday in the Lancet, a major medical journal. The professors, Dr. Paul M. Ridker and Dr. Nancy Cook, pointed out the problems in the calculator earlier this year when the National Institutes of Health’s National Heart, Lung and Blood Institute — which originally developed the guidelines — sent drafts to several professors for review. Though Ridker and Cook reported their concerns at the time, nothing was changed about the calculator before it was released last week. Now, in light of the problems, leading cardiologist Dr. Steven Nissen — chief of cardiovascular medicine at the Cleveland Clinic and a past president of the American College of Cardiology — called for a halt on Sunday to implementation of the new guidelines.

“It’s stunning,” Nissen told the Times. “We need a pause to further evaluate this approach before it is implemented on a widespread basis.”

The American Heart Association also called an emergency session at their annual meeting in Dallas on Saturday night to address the problem, the Times reports. The group reportedly held private meetings with Ridker, whose calculations with Cook indicate that the calculator could be overpredicting cardiovascular risk by 75% to 150%, depending on the population. Later, both the American Heart Association and the American College of Cardiology said while the calculator is not perfect, it is still a big step forward. They recommended that doctors still follow the guidelines released last week and discuss treatment options with their patients, but advised against blind adherence to the calculator.

“We need to see if the concerns raised are substantive,” Dr. Sidney Smith, the executive chairman of the guidelines committee, told the Times. “Do there need to be changes?”

[New York Times]

12 comments
Concerned100
Concerned100

My doctor told me I had cholesterol readings 3 times normal and he suggested that I take drugs for the rest of my life or I could die at any time.

I checked out the drug and found that it causes kidney failure and liver damage over time.

So I decided to include nuts, lemon and pomegranate juice and a daily dose of beer or wine in my diet Also cut out white flour products and potatoes. Stopped eating animal fat and started eating fresh fruit and vegetables. I still eat steak and chicken wings and bacon. But in moderation. I loved pies and ice-cream. Switched to frozen yogurt and have pie once a month.

The result was that my cholesterol dropped to normal, I lost 40 pounds in weight, I can run up stairs instead of dragging myself up slowly and a plus was that I do not now have sleep apnia and my acid reflux is gone.

bobbyposey
bobbyposey

Another problem with the calculator is that it doesn't work with really healthy cholesterol numbers. I've been following the Whole Food Plant Based diet for a couple of years, and now, at age 67, my total cholesterol is 104. I take no prescription drugs, and have normal weight and normal blood pressure. A total cholesterol of 104 is too low for this calculator, yet there's solid research (sources: John McDougall, T.Colin Campbell, Caldwell Esseystyn) to show that for individuals and even whole communities with cholesterol that low, cardiovascular disease is virtually non-existent. Shouldn't the AHA encourage really healthy cholesterol levels, not just what they think is possible on for people who continue eating the S.A.D (Standard American Diet)?

karl2632
karl2632

I tried using this calculator, and found that age was a huge factor. I put in my brother's terrible blood pressure and cholesterol number, but because he was only 38 the calculator gave him virtually zero risk, which meant he wouldn't have been on statins. When he died the coroner found his arteries packed with cholesterol plaques.

On the other hand, almost everybody who is old enough to retire would be on statins per that calculator. But by then it's too late. Treatment needs to happen when people are middle aged and building up the plaques. Even if the major effects of statins are anti-inflammatory as has been suggested, wouldn't it make sense to start treatment when people are in their 30's with the hope of avoiding heart failure in later decades?

I'm not a cardiologist and I hate to speak against those who study a topic more carefully than myself, but I view this method with suspicion. I think calculating a risk of a heart problem or stroke before some age, say 70, makes more sense than calculating it for the next 10 years.

I also have a concern with not monitoring in the long term. I lost 30 pounds and cut my triglycerides from the 500's to less than 100. Those results are out-of-average for sure, but the whole point of follow up testing is to know when people are out-of-average and adjust treatment accordingly.

sixtymile
sixtymile

Gee, not only the .gov can screw up an internet healthcare rollout? I'm so (not) shocked.

Ohyunjoeng
Ohyunjoeng

A lot of things have to change.
Those changes should go in the right direction.

Hermione
Hermione

We, as a nation, are becomming overdrugged and overfed.

Very sad situation indeed.

MiloBendech
MiloBendech

How about

1. more exercise

2. less food

In a world where 10% of the population can't get enough to eat...American celebrate with obesity

I'm shocked that doctors would recommend a pill over improving poor lifestyle and eating habits

AlFish
AlFish

The big pharma holy grail. Daily meds for the most people.

falcon269
falcon269

The whole statin thing is a scam cooked up by the pharmaceutical industry. Now the physician industry is trying to find a graceful exit to its wholesale endorsement of malpractice! Good luck.

bojimbo26
bojimbo26

" This should work , but just to be on the safe side , we recomend you see your doctor " .

firmsoil
firmsoil

Of course it adds up, in filling up the coffers of big pharma it does.

MiloBendech
MiloBendech

@falcon269   You'd think reputable doctors would proscribe less eating, healthier foods and more exercise

Instead they've become pill popping sales representatives