Last week, new guidelines were issued about managing high cholesterol and on Monday morning, Dr. Alicia Arnold joined us to discuss what they mean to us.
Meghan Kulig: What is the big difference between these new guidelines and the previous ones?
Dr. Arnold: We used to focus on getting blood work lab values to certain levels, and now the focus has switched away from purely a number goal to a more personal risk assessment for heart attacks and strokes.
Meghan Kulig: What criteria are doctors looking at for this more personal risk assessment?
Dr. Arnold: If you've had a history of cardiovascular problems, like heart attack or stroke, are between the ages of 40 and 75 with diabetes, have a LDL cholesterol (or bad cholesterol) of more than 190, or a 10 year risk of a heart attack or stroke of greater than 7.5 percent, the guidelines are recommending that you be on a statin medication.
Meghan Kulig: How is that 10 year risk measured?
Dr. Arnold: There are equations that take into account factors such as age, gender, race, cholesterol, blood pressure, diabetes, and smoking status. The idea is to use these parameters to better determine a personal risk level for an individual patient.
Meghan Kulig: What are statins and how do they work?
Dr. Arnold: Statin medications work in our livers to help lower our cholesterol. Too much cholesterol in our bodies can cause blockages in your blood vessels, which can lead to heart attacks and strokes. Statins can help to lower our risk. These new guidelines could lead to a massive increase in the number of people in our country on statins, perhaps even doubling it. Fortunately, there are generic options for statins, which will help keep costs down.
Meghan Kulig: What are the side effects of statins?
Dr. Arnold: Muscle pain is probably the most common. There are other potential side effects too, including rare but potentially serious side effects such as liver damage and severe muscle damage, called rhabdomyolysis. They can also interact with other medications you are taking.
Meghan Kulig: What hasn't changed?
Dr. Arnold: The importance of a healthy lifestyle is still there. While statins are helpful to many people, they don't replace the importance of choosing heart healthy foods, exercise, and avoiding tobacco.