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Panel suggests preventive statin use for adults over 40

Patients at 10 percent risk for having a heart attack or stroke in the next 10 years can benefit from the drugs, according to the new recommendation.
By Stephen Feller   |   Dec. 22, 2015 at 9:30 AM

ROCKVILLE, Md., Dec. 22 (UPI) -- A government task force on health now recommends adults between the ages of 40 and 75 who are at risk for heart attack or stroke take statins.

The U.S. Preventive Services Task Force issued a draft recommendation for people with a 10 percent risk of heart attack or stroke in the next 10 years to take the drugs, but also suggested some with a risk as low as 7.5 percent take the drugs depending on individual diagnoses.

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Although some doctors question whether the potential side effects from statins -- muscle problems and higher risk for diabetes -- are worth it for lower risk patients, the new guideline echoes those issued in 2013 by the American Heart Association and American College of Cardiology. The USPSTF uses the AHA/ACC method for calculating risk, according to the draft recommendation.

"People with no signs, symptoms, or history of cardiovascular disease can still be at risk for having a heart attack or stroke," Dr. Douglas K. Owens, a professor at Stanford University and member of the task force, said in a press release. "Fortunately, for certain people at increased risk, statins can be very effective at preventing these events."

The task force based its recommendation on 18 clinical trials of statin use with adults over 40, finding people between ages 40 and 75, with a risk factor for cardiovascular disease -- high cholesterol, high blood pressure, diabetes, smoking -- and have a 7.5 percent risk of having a cardiovascular event in the next ten years can benefit from statins.

The biggest preventive effect was seen in people with a 10 percent risk, with the task force making a strong recommendation for patients above the benchmark. For people between 40 and 75 with a 7.5 percent to 10 percent risk, statins can be beneficial but the the task force said these patients should consult with their doctors to assess the potential benefits of taking the drug.

"The magnitude of the benefit is different the greater the risk," Owens told Time. "Heart disease risk is a continuum, so the higher your risk, the more likely you will benefit from taking a statin."

The recommendations leave room for discretion, which some have criticized as being vague and not helpful. Dr. Steven Nissen, chair of cardiovascular medicine at Cleveland Clinic, said the recommendation is confusing because it does not definitely suggest anything for some patients.

While the task force notes potential benefits for patients at lower risk, it does not include patients under 10 percent seeing definite benefit from statins because of a lack of research establishing benefits for the lower threshold.

"These recommendations leave as many questions as they give answers," Nissen said. "It doesn't clarify for prescribers and for patients what they should do. I find that exasperating."

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