A Mayo Clinic task force has put together an updated set of recommendations for cholesterol treatment. The last guideline update took place in 2001, and several changes have been recommended, including a recommendation that not all patients currently prescribed statins and other cholesterol-lowering medications should take them. The task force also had new recommendations for people with rheumatoid arthritis or AIDS, and those who had received certain organ transplants.
The American College of Cardiology (ACC) and American Heart Association (AHA) guideline needed to be updated, said Francisco Lopez-Jimenez, MD, task force chairman and director of preventive cardiology at Mayo Clinic in Rochester, Minnesota. The last update took place 12 years ago.
“We agree with many points of the [existing] guideline, but there are some key areas where we do not completely agree or we wanted to expand and provide more guidance,” said Lopez-Jiminez.
Several changes have been recommended.
While the current ACC/AHA cholesterol treatment guideline recommends high doses of the strongest statins to most men over the age of 65, the Mayo task force found no evidence to recommend this based solely on age.
Rather than medication combined with healthy lifestyle habits to prevent cardiovascular disease, the task force recommended lifestyle changes–exercise and diet–followed by an evaluation before prescribing statins.
Diabetics over the age of 40 have been recommended to take statins, but the task force concluded that not all diabetics have the same risk of heart attacks, and recommended against statins in some diabetics over 40: those in whom there is a low risk of heart attack or stroke based on the ACC/AHA calculator.
Rather than making cholesterol medications based on generalities such as age, diabetes and prevention, the task force recommended a treatment approach based on individual needs, and also recommended shared decision-making in treatment.
The task force added some patients to the list of those for whom statins were recommended. Rheumatoid arthritis, kidney and heart transplant recipients, and AIDS sufferers were among the new inclusions.
The recommendations was scheduled to be published in the August 14 edition of Mayo Clinic Proceedings, along with an editorial.
By Heidi Woolf
Changes in Heart Medication Guidelines - Mayo Clinic
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