Editor's pick: Originally published Jan. 5.
The U.S. Preventive Services Task Force loudly threw down the gauntlet when in a pre-Christmas announcement of a pending recommendation it said, in effect, that it likely would be recommending that many adults over 40 take a low dose statin - anti cholesterol pill - for the prevention of cardiovascular disease (CVD) events. That is a big policy shift.
Here is the exact language:
“The USPSTF recommends that adults without a history of cardiovascular disease (CVD) (i.e., symptomatic coronary artery disease or thrombotic stroke) use a low- to moderate-dose statin for the prevention of CVD events when all of the following criteria are met:
* They are ages 40 to 75 years
* They have one or more CVD risk factors (i.e., dyslipidemia, diabetes, hypertension, or smoking)
* They have a calculated 10-year risk of a cardiovascular event of 10% or greater."
Very probably, if you are over 40, soon in this new year your doctor will have a heart to heart with you about taking statins. What should you say?
First however, is this wonderful news for drug companies? Maybe. But Wal-Mart - as a case in point - offers at least one statin, lovastatin, in its $4 per month prescription program. Even once pricey Lipitor - a highly popular statin - now is as low as $10 to $13 for a month’s supply at many large grocers and pharmacy chains. Once expensive, statins now are much more affordable as generics stream into the market.
So why the uproar over the USPSTF draft recommendation?
Partly, there is simple confusion over the per patient calculation of a likely CVD event. That involves plugging a lot of information into an online calculator.
But the bigger uproar is because USPSTF is in effect saying, prescribe statins for people who may be healthy and who have no cardiovascular disease events in order to possibly prevent CVD events...which may in fact not happen.
Should a statin be your daily mix? That is the question.
More doubt arises in a recent study from the Centers for Disease Control that says that many of us who should be taking statins - even before the broader definition via USPSTF - were not. Per CDC, “36.7% of U.S. adults or 78.1 million persons aged over 21 years were on or eligible for cholesterol treatment." But, CDC added, 35.5% reported doing nothing.