A Smarter Way to Prevent Heart Attacks

Under new guidelines, one third of adults in the U.S. should consider using statins based on their overall health profile, not just their cholesterol number

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The well-established strategy among doctors for reducing cardiovascular disease has been to lower bad cholesterol, or LDL, to specific targets (below 100 or below 70 for people at high risk). No more. New clinical guidelines unveiled Tuesday take a more broad approach to assess a patient’s risk of heart disease and to prescribe twice as many Americans (one third of all adults) cholesterol-lowering statin drugs, the Wall Street Journal reports.

The cholesterol numbers have been deemed arbitrary and worse predictors of heart risk than doctors originally thought. Now, doctors are being told to dive more deeply into a patient’s background to assess their potential risk for heart attacks and to prescribe cholesterol-lowering statin drugs to high-risk patients. The formula for whether a patient ought to be prescribed a drug will include age, gender, race and factors beyond cholesterol, like whether someone smokes.

Though doctors say the new approach will limit how many people will be put on statins because of their cholesterol number, under the new formula, 33 million Americans — 44 percent of men and 22 percent of women — would meet the requirements to consider taking a statin. The current guidelines only recommend statins for 15 percent of adults.

And for the first time the treatment is focusing on strokes, not just heart attacks. “We’re trying to focus the most appropriate therapy to prevent heart attack and stroke…in a wide range of patients,” said Neil J. Stone, professor of medicine at Northwestern University Feinberg School of Medicine and head of the panel that wrote the cholesterol guidelines.

In the U.S., 600,000 people per year die from heart disease (accounting for about one in four deaths).