Last week, we all awoke to a sea-change in the way mainstream medicine approaches the prescribing of cholesterol drugs. It caught many of the "worried well" by surprise. Even most doctors were blind-sided.
Prescriptions for "statin" drugs—like Lipitor, Zocor, Pravachol and Crestor—have soared over the past decade, fueled by clever TV ads and guidelines put out by the American Heart Association and the National Heart, Lung and Blood Institute. Currently, 37 million Americans take these drugs.
But now, the revised guidelines will cast an even wider net. It's estimated that once they're implemented, the number of Americans taking statins could double.
What are the implications for you or a loved one? Should you get on the statin bandwagon, or should you buck the trend? Here's an analysis.
First of all, here's something good about the new guidelines: They actually offer a concession that our single-minded obsession with cholesterol is misguided!
How can that be when statin drugs are designed to lower cholesterol? Heart disease researchers now finally admit that cholesterol levels should not be the sole determinants of who should get aggressive treatment to lower heart disease risk. The previous guidelines were simplistically fixated on levels of the so-called "bad" cholesterol—LDL, or low density lipoprotein.
The unfortunate result has been that some people with high LDL but with low risk were subject to "cholesterol limbo" (how low can you go!); others with seemingly good LDL but other risk factors were missed.
Additionally, the revised guidelines finally discourage over-zealous doctors from tanking up patients on super-high doses of statin drugs to achieve unrealistically low LDL targets. Why? The cardiology establishment has finally had to admit that statins work not so much by lowering cholesterol, but more by acting like expensive super-aspirin: they reduce inflammation that damages artery linings and sets the stage for plaque accumulation.
Thus, a moderate dose of statin drugs confers protection, even if cholesterol levels aren't totally normalized. So far, so good. But the new guidelines are imprecise and overly broad. They call for four groups of patients to get statins: