New Statin Guidelines: What You Need to Know

Nov 21, 2013
Recently, the ACC/AHA released new guidelines regarding statin therapy. Specialist pharmacist Ed Dannemiller provides information about these changes.

New guidelines from the American College of Cardiology and American Heart Association have the potential to significantly change the way HMG-CoA reductase inhibitors – more commonly known as statins – are used to treat high cholesterol. 

Disease-Focused Understanding

The new guidelines are focused on lowering the risk of atherosclerotic cardiovascular disease – generally characterized by clogged arteries. Previous treatment goals set a specific level for LDL, or bad cholesterol. Based on years of evidence-based data, the new guidelines focus instead on actually lowering the risk of cardiovascular events by prescribing a moderate to potent statin therapy. For instance, rather than aiming to bring a patient’s LDL level below 100, the therapy would be aimed at minimizing the patient’s risk of a heart attack or similar adverse event.

The American Heart Association expects that implementation of these risk-reduction guidelines will help to substantially address the large burden of fatal and nonfatal cardiovascular events in the U.S.

Understanding how these guidelines affect your treatment can be daunting. A specialist pharmacist in the Express Scripts Cardiovascular Therapeutic Resource Center with disease-specific expertise and training in these conditions can help.

Here is what you need to know about the new guidelines.

Statin Use by Patients

The new guidelines recommend statin use for four categories of patients:

  1. Patients who have already had a cardiovascular event, such as heart attack, stroke, angina or transient ischemic attack
  2. Diabetes patients between ages 40 and 75 with LDL greater than 70
  3. Those without a history of diabetes or cardiovascular event but with primary LDL level greater than 190
  4. Those aged 40 to 75 with LDL less than 190 and an estimated 10-year risk of having a cardiovascular event of 7.5% or higher

These four groups are the most likely to benefit from moderate to potent statin therapy.

The new guidelines do not provide recommendations for the use of nonstatin cholesterol therapy since there isn’t enough evidence available to show that these medications reduce the risk of cardiovascular events. You should talk to your physician to determine whether a nonstatin medication is appropriate for you.

The Bottom Line

The new guidelines are part of a package of recommendations to reduce the risk of heart attack and stroke. Lifestyle changes such as moderate exercise, weight loss and a healthy diet still play an important role in treating the disease. The major change is that depending on where you fit in the four categories of risk, your physician may recommend you use either moderate or potent statin therapy.

The new guidelines have the potential to increase the number of people receiving statin therapy because it provides expanded guidance on who can benefit most significantly from statin therapy.

The Value of Clinical Specialization

With our specialized training as cardiovascular specialist pharmacists, my team and I can help address any concerns about the new guidelines. We are here to be a part of your healthcare team and help you make the best decisions for your health.

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