New guidelines for preventing heart disease with statin-type drugs are still causing controversy, as they have been since they were released over two years ago. We wrote about the kerfuffle then, but now there is more.
A group of cardiologists from Johns Hopkins and the Mayo Clinic have suggested that the American Heart Association’s Risk Calculator overestimates the likelihood of a heart attack or stroke. That’s because the algorithms that were used relied upon data from the 1970s and 1980s. In those days people had risk profiles that were substantially worse than current patients who are more conscious of diet and exercise.
What Are the Consequences of Inaccuracies in the Risk Calculator?
These flaws in the risk calculator would likely lead to overtreatment with statins. For example, a 63-year-old man with total cholesterol of 180, good HDL cholesterol of 60, blood pressure of 120 over 80, no history of diabetes and not a smoker would still be told to take a statin even if he was a vegetarian and a long-distance runner.
The cardiologists from Hopkins and Mayo recommend using data from electronic medical records to refine the risk calculator in order to better target people who will benefit from statins.
Mayo Clinic Proceedings, Aug. 11, 2015
What Is the Downside of Statin Overtreatment?
This argument could be considered academic, if it were not for the fact that statin-type cholesterol-lowering drugs are not completely benign.
Although many people can take drugs such as atorvastatin (Lipitor), rosuvastatin (Crestor), pitavastatin (Livalo) or simvastatin (Zocor) without obvious difficulties, the medications can disrupt blood sugar control and even lead to diabetes. They also increase the likelihood of developing cataracts.
Muscle pain and weakness may be one of the most common complaints, but people are also concerned about brain fog, sexual dysfunction and long-lasting nerve pain (peripheral neuropathy). A small risk of any of these potential side effects might be worthwhile for a great benefit of avoiding a heart attack, but if the risk calculator has overestimated a person’s chances of a heart attack, the benefit is less than expected.
You can learn more about the pros and cons of statins and other ways to keep your heart healthy from our Guide to Cholesterol Control and Heart Health.
