WASHINGTON — Criticism over new cholesterol treatment recommendations appears to be growing, judging by remarks made by cardiologists this week at the annual meeting of the American College of Cardiology, the group that issued the new guideline last November along with the American Heart Association.
Doctors are supposed to use the guideline to help them determine whether to prescribe statins for patients without heart disease to prevent future heart attacks or strokes. But cardiologists complain that a new risk calculator tool — which takes into account age, race, gender, and heart risks such as high blood pressure and cholesterol — overestimates cardiovascular risks, especially in older Americans.
“I don’t know anyone who’s using it,” Dr. Rita Redberg, a cardiologist at UCSF School of Medicine, said during an interview at the meeting. “I still use the old Framingham risk score to assess heart attack risk.” (The latest version of Framingham is more than a decade old and doesn’t predict stroke risk.)
She and others are concerned that the new risk calculator tool will result in more healthy patients being unnecessarily put on statins to prevent heart disease. Brigham and Women’s Hospital researchers estimated that the risk tool overestimated heart risks by 75 to 150 percent in a paper published last fall in the journal Lancet. And a new Duke University analysis published last month in the New England Journal of Medicine predicted that the calculator tool would make 13 million more American adults eligible for statins, including 87 percent of men ages 60 to 75 and 54 percent of women in that age group.
“The tool puts a far greater percentage of Americans in the high-risk group for heart disease, but that implies a certainty that we don’t really have,” said Dr. Michael Blaha, a clinical research fellow at Johns Hopkins Heart and Vascular Institute, in a presentation he gave at the meeting. “In some ways, it’s a step backward because it puts so much reliance on age to assess risk.”
You see a lot of nonsense on the web about Big Pharma inventing reasons for people to take drugs so they can make fatter profits. I’ve even seen that said about vaccines, which is a total groaner. (Vaccination has to be taxpayer-subsidized because there’s no profit in it.)
But this looks to me like a clearcut case of Big Pharma moving the goalposts right into the bank. All they changed is the *definition* of who is “sick.” There hasn’t been any breakthrough or new data. So they expanded the pool of customers to all old people and then said the elderly need constant medicating with patented multi-thousand-dollar drugs.
Ratbags.
dependingon the type of statin, the funny thing is that if you alter cholesterol pools in neurons, you dramatically increase the risk of Alzheimers. Yes, the confounding variable is also that if you decrease the risk of cardiovascular damage (like stroke) you also dramatically reduce the risk of Alzheimers. So you win some you lose some.
Meanwhile some statins seem to pleiotropically reduce the risk of of Alzheimers — I say that because the statn with the longest hal-like in the blood and the highest cross section for passing th blood brain barrier is least likely to affect Alzheimers progression. Counerintuitive if reducing cholesterol in the brain were important — n fact again, probably rearrangong the pools of ChE is not a good idea anyway, as it leads to more Abeta production via a known mechanism involving the distribution of gamma secretase in lipid rafts.