Doctors are now using a new approach to treat cholesterol with statins. This approach relies less on cholesterol numbers (specifically the LDL), and more on cardiovascular risk factors (smoking, diabetes, age, high blood pressure).
To determine if a patient needs a statin, their risk for cardiovascular disease (heart attack, stroke, etc) over the next 10 years is predicted using a formula. This is called the pooled cohort risk factor score. If one’s risk is over 7.5%, this is concerning, and statin therapy is recommended. Statins are recommended in other groups as well:
- Diabetics, Type I and II, ages 40-75, regardless of cholesterol values
- Known cardiovascular disease (history of heart attack, stroke, or known PVD, etc)
- Patients over 21 with LDL over 190
We know that statins prevent cardiovascular disease in ways other than just lowering LDL so that is why there is less emphasis on “perfect numbers”. By using statins, we can prevent much cardiovascular disease, a major cause of death and illness in this country. You should discuss your own risk situation with your physician. There are other factors that are not currently addressed by these guidelines (age over 75, strong family history of heart disease) and these may be important in your decision regarding statin therapy.