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Doctors Challenge New Statin Guidelines

Algorithm may overestimate cardiovascular risk (November 19)

According to two experts at Harvard Medical School, a new online cholesterol risk calculator released Nov. 13 by the American Heart Association (AHA) and the American College of Cardiology (ACC) overstates a person’s risk of heart disease. In the experts’ view, the calculator could mistakenly suggest that millions of people should be taking cholesterol-lowering statin drugs.

When the calculator went online, Professors Paul M. Ridker and Nancy R. Cook tested it and reported that the new calculations could result in more than 45 million middle-aged Americans who do not have cardiovascular disease being recommended for statin therapy. Moreover, according to their analysis, the calculator’s risk-prediction algorithm overestimated observed risks by 75% to 150%, roughly doubling the actual observed risk.

“Reliance on the new risk prediction algorithm could put many primary prevention patients on statin therapy where there is little trial evidence, while potentially denying statin therapy to other patients despite trial evidence of efficacy,” they said.

Their findings were published in the Nov. 19 edition of The Lancet.

AHA and ACC officials responded that the Harvard professors’ analysis of the calculator relied on data from three heart studies involving people who were both younger and healthier than the average American.

The officials added that just because the calculator suggests some people would benefit from statins doesn’t mean they have to take them.

Sources: Lancet; November 19, 2013; and Medical Xpress; November 18, 2013.

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