Understanding the new cholesterol guidelines

By Dr. David Peterson | Mar 14, 2014
Photo by: Donated Dr. David Peterson

When American Heart Association and American College of Cardiology released new cholesterol guidelines in 2013, the goal was to help reduce heart attack and strokes, however many people have questions about the differences between the new and old guidelines.

One of the main differences is that there is now more of a focus on risk factors rather than simply focusing on the LDL — the “bad” cholesterol — number. There are certain groups of people, who, if they receive specific types of treatments from doctors, can have less of a chance of having a heart attack or a stroke.

Some of those groups of people are people with a certain heart condition known as ASCVD (arteriosclerotic cardiovascular disease); people with acute coronary syndrome (reduced blood flow to the heart); people with a history of heart attack; people with stable or unstable angina (which is chest pain from reduced blood flow to heart); people who have had a stroke, TIA or what is known as mini stroke; individuals 45-75 years of age with diabetes and a certain level of LDL-C (ask your doctor about the range they are looking for).

There are other groups, and doctors will use a ‘risk calculator’ to determine what your risk will be for having heart issue within the next ten years. So, when doctors identify patients who fall into one of these categories, they will do things like prescribe statin therapy.

The overall goal is to obviously reduce the number of cardiac events as well as strokes and TIA’s (mini-strokes). Some of the arguments about these guidelines is that it is only benefiting the pharmaceutical industry. Patients have to realize that all except for one of the current heavily used statin drugs are generic, and generally low-cost.

The use of statin therapy continues to be a discussion between the doctor and the patient, as statin therapy has some potential side effects.

In addition to statins, changing your lifestyle to include a heart healthy diet, building regular exercise habits, avoiding tobacco products, and maintaining a healthy weight, all remain a critical components of having a healthy heart.

My recommendation is to have a conversation with your doctor about how to maintain a healthy heart.

Dr. David Peterson is a cardiologist at Western Carolina Cardiology in Clyde, and is on the medical staff at MedWest Haywood.

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