Cardiologists at the annual meeting of the American Heart Association are feuding over new guidelines for statin prescribing. Last week experts from the AHA and the American College of Cardiology revised their recommendations for treating millions of patients. Instead of pegging treatment to cholesterol levels, they presented a tool called the CV Risk Calculator. This questionnaire takes into account age, gender, race, total cholesterol, HDL, blood pressure, diabetes and smoking history.
This week, however, researchers from Harvard pointed out that the risk calculator does not work very well. It overestimates risk by 75 to 150 percent. This is likely to lead to overprescribing of statins.
Cleveland Clinic cardiologist Steve Nissen called for a pause before widespread implementation of the risk calculator, but the cardiology organizations defended their work. It may take some time for the cardiology community to resolve this internal controversy. In the meantime, patients will need to exercise their best judgment as to whether or not a prescription for a drug like atorvastatin or simvastatin makes sense.
We discussed the new guidelines on our hour-long radio show (#925) before the controversy had fully erupted, but the varying perspectives are clear.
