Statin use recommendations for cholesterol vary in US and Europe

Statins are commonly used to lower cholesterol, therefore helping to reduce the risk of cardiovascular disease. But new research finds that US and European cholesterol guidelines differ significantly when it comes to statin use recommendations, meaning many individuals may not be getting the correct treatment.

This really is based on research lately printed within the journal JAMA.

Coronary disease (CVD) is really a primary reason for dying in america. Primary risks for that condition include high bloodstream pressure, weight problems and cholesterol. A number of these risks could be removed by lifestyle interventions, however, many may require assist with medication – for example statins – in lowering cholesterol.

To look for the how to treat patients vulnerable to CVD, nearly all physicians follow recommendations set by either the nation’s Cholesterol Education Program expert panel (ATP-III recommendations), the American College of Cardiology/American Heart Association (ACC/AHA) task pressure and also the European Society of Cardiology (ESC).

But based on detectives from Erasmus MC-College Clinic within the Netherlands, “different methods to CVD risk estimation and use of different criteria for therapeutic recommendations would result in substantial variations in space of people qualifying for treatment in a population level.”


Research finds that different cholesterol recommendations result in different statin use recommendations.

With this thought, the scientists desired to determine precisely how these different recommendations affected clinical practice inside a population of four,854 Nederlander participants, all whom were aged 55 years or older.

The detectives calculated the participants’ 10-year risk for major CVD occasions, including fatal and nonfatal heart disease (CHD) while using ACC/AHA guideline.

Their risks were also calculated for major CHD occasions, for example fatal and nonfatal cardiac arrest and CHD mortality – while using ATP-III guideline – and CVD mortality risk was assessed using ESC guideline.

For every guideline, the share of people who’d be suggested statins was calculated.

Differing statin use and CVD overestimation

The researchers found that under the ACC/AHA guideline, statins would be recommended for 96.4% of men and 65.8% of women, while under the ATP-III guideline, statins would be recommended for 52% of men and 35.5% of women. Under the ESC guideline, 66.1% of men and 39.1% of women would be recommended statins.

Using the ACC/AHA guideline, the researchers found that the average predicted risk of major CVD events was 21.5% for men, while actual CVD events came in at 12.7%. For women, predicted risk of major CVD events was 11.6%, compared with actual CVD events at 7.9%. The researchers say that similar overestimations were found using the ATP-III and ESC guidelines.

Commenting on their findings, the researchers say:

“Beyond the need for improving the risk predictions and setting appropriate population-wide thresholds to facilitate better clinical decision making, the large proportion of the population recommended for statin treatment based on new guidelines should be a concerning signal.”

“These large numbers point out the need for (1) preventing risk factor aggregation and (2) conveying information to individuals in ways that effectively lower their risk, in an era when cardiovascular disease remains a worldwide public health challenge.”

This research comes just as a new study suggests that under new guidelines from the American Heart Association, 13 million Americans will be deemed eligible for statins.


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