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On November 12, 2013, the American Heart Association and the American College of Cardiology issued new cholesterol guidelines, which means that doctors are changing the way they prescribe treatment for patients with high cholesterol. There has been a shift in the way high cholesterol is being treated, and it could double the amount of people who take cholesterol medications called statins. If you are not on cholesterol-lowering drugs, there is a chance you could be soon. These new guidelines call for looking at risk factors and not just the numbers/cholesterol levels.
The biggest change you can expect to see is that your cholesterol number is not as important as it used to be. Doctors used to want to medicate people to get their LDL levels below 100. This thinking has changed. Instead doctors will use specific risk factors when determining whether a patient should take statin drugs or make lifestyle changes. And many people who will take statin drugs should also look at their lifestyle factors as well.
Four risk factors for heart problems
There are four questions used to assess risk for heart problems and to determine if a patient should take statins
- Do you have heart disease?
- Do you have diabetes?
- Is your LDL (bad) cholesterol level over 190?
- Is your 10-year risk of heart attack more than 7.5%
According to the new guidelines, if you answer yes to any of these four questions, you should be on a statin. If you do not fit the above criteria, you should be able to manage your high cholesterol through lifestyle changes and managing your behavior. Doctors will also consider your age, race, weight, blood pressure, and whether you smoke.
The goal is to lower cholesterol, but it is also to get people to adopt a heart-healthy lifestyle to give patients the best chance of lowering their risk of stroke or heart attack in the next ten years.
Lifestyle changes for lowering cholesterol
These new cholesterol guidelines work at preventing major heart problems. Lifestyle is an important component of reducing your risk of chronic disease. What can you do to help your heart health? Exercise is important. Exercising three to four days a week can work twice as better than medication to reduce your risks. Diet is also important, as is maintaining a healthy weight. There are cholesterol lowering foods you can eat and other heart healthy dietary changes you can make. One of the best diets for heart health is the Mediterranean diet. If you are overweight, you might want to talk to your doctor or a dietician about what changes you can make to lose weight and lower your cholesterol.
Statin drugs and cholesterol guidelines
Statin drugs can cause some side effects such as muscle pains and soreness. They may increase risk of type 2 diabetes and liver disease. Diet and exercise do not cause as many side effects as medications, which is also part of why lifestyle is important for preventing disease.
Heart disease is the leading cause of death for men and women in the U.S. About 25% of adults over age 45 in the U.S. currently take statin medications. While even more people may start taking statin drugs, the focus of these changes in cholesterol guidelines is to get people to lower their cardiovascular risk factors through diet, exercise, weight loss, and related lifestyle changes as well.
Stone NJ et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Circulation 2014;
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