More than 45 million Americans take daily cholesterol medication, according to Yale Medicine. When taken orally, statins can help lower cholesterol and, consequently, reduce your risk of developing heart issues, blood clots, and stroke. And while studies show that statins like Lipitor, Crestor, Zocor, and Altoprev are safe and effective in patients with high cholesterol and cardiovascular disease, a new study suggests that those who take statins for early prevention may not need to.
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But first, it’s important to understand how statins work. For starters, “they lower the amount of bad cholesterol in the bloodstream that can be deposited in the arteries,” Yale Medicine cardiologist Brian Cambi, MD, explained.
Secondly, statins work to “stabilize the covering over plaques, rendering them less likely to rupture, thereby decreasing the chance of an unstable plaque or heart attack,” he continued. And third, statins put up “roadblocks” that prevent cholesterol from depositing into the lining of the vessel wall.
For the last decade, doctors have been evaluating patients for statin medication based on the 2013 guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC), all of which take into account a person’s age, blood pressure, diabetes risk (or diagnosis), race, and more.
As for the new study published in JAMA Internal Medicine, doctors utilized the AHA’s new heart disease risk calculator, PREVENT, which estimates absolute risk in adults ages 30 to 79. A more modern method, PREVENT considers risk factors like kidney disease and obesity. Patients can also calculate their risk for heart disease based on sex.
Researchers pooled 3,785 participants (ages 40 to 75) and calculated their 10-year risk of developing heart disease using PREVENT versus the 2013 guidelines. When they compared the two methods, they found that PREVENT’s estimate was significantly lower, which begs the question: Do you still need to take statins for heart risk prevention?
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“Findings of this study suggest that use of the PREVENT equations could greatly reduce the number of patients eligible for primary prevention statin therapy,” researchers concluded in the study.
“Based on PREVENT equations, 17.3 million adults who were previously recommended primary prevention statin therapy would no longer meet eligibility, including 4.1 million adults currently taking statins,” they added.
That said, PREVENT doesn’t take into account family history, which is arguably one of the most important risk factors, especially if high cholesterol and cardiovascular disease or events (like stroke) run in your family.
“For patients who are right on the edge, they should know that there are other things not captured by these calculators, like family history, so it’s very important to discuss this with their physician,” Timothy Anderson, MD, who co-authored the study, told NBC News.
Additionally, medical officials warn that PREVENT should be used in conjunction with new guidelines.
“Risk models don’t determine who is recommended to take statins, guidelines do,” Sadiya Khan, MD, who was chair of the committee for PREVENT development, told NBC News. “I think the most important thing is the determination of when it will be recommended to initiate statins. That has not been decided yet.”
To that end, Shaline Rao, MD, director of heart failure services at the NYU Langone Hospital-Long Island, said that patients shouldn’t skip their cholesterol medication because of an online test and without speaking to their doctor first.
“We see a lot of benefits of statins across many populations,” Rao told NBC News.
Best Life offers the most up-to-date information from top experts, new research, and health agencies, but our content is not meant to be a substitute for professional guidance. When it comes to the medication you're taking or any other health questions you have, always consult your healthcare provider directly.
