Medical Moment: Statins, For You?

Medical Moment: Statins, For You?

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Dr. Kent Gaylord, Board Certified in Family Practice

Dr. Kent Gaylord, Board Certified in Family Practice

Dr. Kent Gaylord answers this week’s question: Should I be prescribed statins?

Statins (or HMG-CoA reductase inhibitors) are a class of drugs used to lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver, which produces about 70 percent of total cholesterol in the body.

Recently the American College of Cardiologists and the American Heart Association (ACC/AHA) released new cholesterol guidelines.

These new guidelines have received lots of national press and have caused some controversy in the medical community. The new guidelines recommend that doctors focus more on overall risks to the heart and less on cholesterol numbers.

Here’s a summary of the new recommendations:

The foundation of the new recommendations starts with healthy lifestyle habits including regular exercise, eating a hearth healthy diet and maintaining a healthy weight.

There are four groups that the ACC/AHA have identified as being candidates for using a statin medication:

1. Patients who already have heart disease (those who have had a heart attack, stroke, coronary heart disease)

2. Patients with a LDL greater that 190 on their cholesterol blood test

3. Patients with diabetes, either type 1 or type 2

4. Patients with a 10-year heart disease risk greater than 7.5%, as identified on an online ACC/AHA risk calculator

It is this last group of patients (#4) that have garnered so much controversy, with some doctors saying it overestimates the number of people that need to be on statins.

To determine that risk, doctors use an online calculator that figures out the chances of having heart problems in the next 10 years.

The calculator takes into account cholesterol numbers, age, blood pressure, if you have diabetes, sex, race, smoking habits, and use of blood pressure medicines. All of these things affect your chance of having heart problems.

If you are a candidate for a statin, rather than targeting a certain cholesterol number, the new guidelines suggest patients lower their cholesterol by a certain percentage (typically 30 to 50% depending on your cardiovascular risk). The old guidelines suggested targeting a specific cholesterol number.

It may take some time for the controversy of the new guidelines to be worked out, but if you have any questions regarding your cholesterol and heart risk, it would be prudent to make an appointment with your medical provider.


Editor’s note: The Telluride Medical Center is the only 24-hour emergency facility within 65 miles.As a mountain town in a challenging, remote environment, a thriving medical center is vital to our community’s health.

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