Ask a Doc: Should everyone over 40 be on cholesterol meds?

Ask a Doc: Should everyone over 40 be on cholesterol meds?

Q: I read recently that the U.S. Preventive Services Task Force (USPSTF) is now recommending everyone over age 40 be screened for the use of statins. Is this true?

Dr. Raminder Singh M.D., interventional cardiologist with Advocate Heart Institute, weighs in.

A: First, it’s important to understand that there are currently no national guidelines for the use of statins – which are drugs used to lower or manage cholesterol. Different medical societies and associations have somewhat differing guidelines.

Most cardiologists follow the American College of Cardiology (ACC), which significantly changed its guidelines in 2013 in partnership with the American Heart Association (AHA), though not without some controversy. These guidelines aimed to cast a wider net among patients who may be at risk for cardiovascular disease by looking past LDL or “bad cholesterol” levels to develop a more comprehensive risk profile including weight, blood pressure and lifestyle factors.

The new guidelines by the USPSTF casts this net a bit wider still for starting statins as a preventative measure for those who may be at risk for cardiovascular disease by focusing more on age than current ACC/AHA guidelines. The task force recommends people ages 40 to 75 who have one or more risk factors — such as high cholesterol, high blood pressure, diabetes or smoking that put them at a 10 percent or greater risk of having a heart attack or stroke in the next 10 years — should be on statins. The report also claims those at 7.5 to 10 percent risk may benefit from statins, but does not go so far as to recommend them (whereas ACC/AHA guidelines do).

The guidelines have not changed for patients who already have had a clinical atherosclerotic disease such as coronary artery disease, stroke, peripheral artery disease, etc. These patients should be on maximally tolerated high intensity statin doses per ACC guidelines.

It is important to understand that USPSTF makes recommendations about the effectiveness of specific preventive care measures for patients who do not have obvious signs or symptoms. In fact, their recommendations are used as benchmarks for coverage by the Affordable Care Act and Medicare.

Your physician uses guidelines as just that – a helpful guide to develop a customized plan for care for your unique health needs. Getting your annual physical with your primary care physician and knowing your numbers – blood sugar, blood pressure, cholesterol and weight – are critical first steps in preventing cardiovascular disease or other health issues. Together, you and your physician can decide what lifestyle changes and drug therapies – if needed – are right for you.

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14 Comments

  1. I really find the recommendations very unsettling! Really? I’m sure the drug companies will love this…I wish people would quit being “lumped’ into categories and start being treated as individuals. Everyone’s health is unique and their healthcare they receive should be individualized as such!!!

    • I completely agree. Too many people- including doctors- think taking a pill solves everything. No one looks at the alternatives. Exercise, diet.
      I have fairly high cholestrol but my HDL is very high because I exercise. Everything I read tells me I am OK.
      Instead of a pill- try eating oatmeal every morning for breakfast. I guarantee it will drop the cholestrol number.

  2. My mother is diabetic, and based solely on this fact, her endocrinologist has tried to put her on cholesterol medication and blood pressure medication, despite the fact that all her levels cholesterol, blood pressure, etc are normal, and there is no family history of heart problems. These medications have SIDE EFFECTS which are sometimes very serious. There was a pretty significant period of time when my mother couldn’t exercise because these totally unneeded medications were causing muscle weakness. How is this the best solution for her health? She’s managed to talk her doctor out of the pointless BP meds, and she doesn’t take her full dose of the cholesterol meds (those are the ones that were causing the muscle weakness), but it’s exactly these types of recommendations that her doctor is following. She’s gone to other doctors in the area, and they all have the same approach. This is exactly the wrong direction for the medical community to be taking.

  3. Absurd. Statins should be a last resort. Compliance with station therapy, for just one year, is around 50%. Why? Adverse events. For all their claimed benefits, these drugs make around half the people who take them miserable enough to quit.

    Another interesting ‘half’: many studies point out that fully half of sudden cardiac death victims, more than half of all CVD patients, and more than half of those hospitalized for a heart attack have “normal” cholesterol levels.

    Blanket recommendations, especially for health intervention, using words like “all”, “everyone”, etc are irresponsible, and reveal much about the person doing the recommending

  4. Concerned Consumer December 1, 2016 at 12:38 pm · Reply

    A whole foods, plant-based diet can eliminate all potential concern about high cholesterol and chronic disease! This topic is rarely discussed and almost never featured on AHC Healthe News. Please consider using “Ask a Doc” to examine the high-reward of vegetarian/veganism vs. the high-risk of consuming animal products.

    I cannot believe that any association like the USPSTF is taken seriously about the issue of Preventative Health with information like this. They should not get away with pushing the direct interests of Pharmaceuticals, and be considered “preventative” in nature. Americans need to wake up! It’s what we eat! “Getting old” never meant drugs and surgery by default until Big Pharma Business lobbied our Government.

    I will be steering clear of anything the USPSTF recommends. They present themselves as a veiled pill-pusher here. Sincerely,
    Concerned Consumer

  5. Marjorie Pomonis December 1, 2016 at 1:27 pm · Reply

    Statins caused muscle weakness to the extent I could no longer take them even at the lowest dose. Even after being off them for more than 6 years my cpk values and muscle weakness continue. They are not for everybody no matter what the guidelines say.

  6. Far too many medications have become ‘standard issue’ items, particularly among seniors. Statins can have muscle deterioration effects on people (I am one) & despite all my cholesterol readings being absolutely normal, I was issued a statin. After 4 years, I stopped entirely and switched to a natural way of exercise & food choices. My readings are the same healthy ones I had while taking the statins but now I’m dealing with muscle weakness. All these ‘standard issue’ medications are meant to benefit big pharma and the doctors don’t block them. GET BIG PHARMA OUT OF OUR GOVERNMENT.

  7. This is really sick. While Statins, nearing a trillion dollars in sales, all of there side-effects in papers were known before they were approved, have been effectively ignored by the approval process. Do you want advanced aging? Early Dementia and premature Sarcopenia. Ask you doctor for a Statin now so you can spend an extra 5 years brain dead in a nursing home to save 3 months of life as a ‘Statin Zombie’? Well that is what you get. Remember your purpose when you get old is to support the medical and pharmaceutical industries in USA. Even in countries that have good single payer systems like Europe, Statin money has corrupted the medical profession. They damage irreversible the molecular energy production system wide ( 3 of the most popular pass the brain barrier and damage the brains energy production system as well (mitochondria). Well, some renowned doctors across Europe about 30 of them put out a paper trying to figure out a way to get people who have muscle damage from Statins (all do just if you have enough muscle reserve issue you do not feel the pain YET.) to still take Stains. Of course all acknowledged relationships with the pharmaceutical industry. Omega-3s with reduction in ingestion of Omega-6 produces all of the positive effects of Statins without all the sever quality of life side-effects. Basically reduce the serum inflammatory molecules an order of magnitude or so.

  8. Would be helpful to include a generally accepted cardiovascular risk assessment tool so an individual could put in their relevant date, i.e. age, height, weight, meds or medical problems, lipid numbers etc to get an assessment of risk of heart attack/stroke in the next 10 years of their life, if such a risk assessment tool exists and has been validated.

  9. Muscle pain and muscle wasting, brain fog, dizziness, diminished physical and mental function, depression and elevated blood pressure all started with statin use. Totally healthy before using this supposed miracle drug. My physician ignored my complaints and told me it was all a normal part of aging. Finally took myself off the drugs when I started constantly losing my balance and falling. Never again! Statins are poison to a large percentage of the population.

  10. I totally disagree. Prime example, my best friend was on statins for preventative reasons, and ended up having a five vessel CABG done anyways many years down the road, and eventually 5 years after the CABG she had a stent placed. She was a long time smoker who had quit after the CABG, but unfortunately only for a short time. She had a family history of heart attacks on the female side of the family. Those statins did nothing to keep her from dying. Quitting smoking might have helped. She ended up having to take effient after the stent placement, and 30 days after had hemorrhagic stroke. She was 64. To this day I feel the effient (or prasurgel) was a contributing factor to her stroke.

  11. WAKE-UP PEOPLE, BIG PHARMA AND THE MEDICAL INDUSTRY ARE WORKING TOGETHER TO MAKE EVERY AMERICAN TAKE A STATIN DRUG AND/OR SOME DIABETIC MEDICATION. THESE DRUGS ARE CASH-COWS FOR THEM. MOST DOCTORS TODAY SHOULD JUST CALL THEMSELVES PHARMACISTS.
    LOOK AT HOW THE CRITERIA FOR HAVING HIGH BLOOD PRESSUE OR DIABETES, OR CHOLESTORAL HAS CHANGED OVER THE LAST 30 YEARS….ALL TO THE BENEFIT OF DRUG COMPANIES.

  12. So the US government gets a pay day and a reputation for their wonderful “preventative” research, while the execs and their shareholders of the huge pharmaceutical companies can get filthy rich… all while our families/friends/grandparents/etc. are paying the ultimate price. This is exactly why so many people voted against the democratic party’s causes in the election this year- the government needs to get OUT of our healthcare system. Get their hands OUT of our pockets. Healthcare worked when it was a free enterprise- experts in all fields making better products, services, and ways to reach people. Let the scientists, doctors, and scholars give their own recommendations about the human body and how it is afflicted, based solely on observation and the scientific method, free from any dirty money or government-sponsored “preventative health” programs aimed at upping profits for big pharma, like the USPSTF. I really feel for the huge population of older adults who are sucked into taking unnecessary drugs because their docs, clinic, government-subsidized insurance plan or whatever told them to do so- without getting to know them or their health or recommending a natural remedy that may be of better help. Doctors should never feel pressured to prescribe drugs because they are concerned about their insurance payouts, perks from pharmaceutical companies, or from their own CEO’s to up profits and make the hospital look great for be being so preventative & in line with the latest trendy health guidelines- it’s not right and the direction we want to be going is AWAY from more drugs- humans were not meant to extend their lives by maybe helpful, but potentially deadly, substances that may take away their willpower, stamina, and so much more.

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About the Author

Tonya Lucchetti-Hudson
Tonya Lucchetti-Hudson

Tonya Lucchetti-Hudson, health enews contributor, is public affairs and marketing director at Advocate Sherman Hospital in Elgin, Ill.

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