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Looking at the new statin guidelines

Posted: November 15, 2013 10:26 a.m.
Updated: November 18, 2013 5:00 a.m.

About one in four Americans, according to one set of statistics in 2010, take medication to control cholesterol. I’m one of them.

Sometime back in the mid- to late-1990s, my employer sponsored an on-site health clinic. They conducted a number of screenings, including cholesterol and triglyceride levels. Mine were off the charts -- to the point where my triglyceride level couldn’t even be measured.

For those of you more familiar with talk of cholesterol, triglycerides are, according to WebMd, “fat in the blood and are used to provide energy to the body.” Having too many lipids (as they are also called) has been linked to a greater chance for heart disease. The same test is used to detect high triglyceride levels as for high cholesterol.

My doctors figured out that while my elevated levels are somewhat related to diet, my extremely high levels are genetically handed down. I could eat absolutely right (which I admit I don’t) and I’d still have higher than normal levels, although lower than not watching what I eat.

So, in the years following that screening, I’ve taken various medications, including Lipitor or, more recently, a generic form of Zocor; and Triglide, a generic form of fenofibrate. My blood tests have shown that they actually do work in my case. My cholesterol and triglyceride levels come down to near, if not right at normal levels. There have, unfortunately, been times when I haven’t taken my medications and the tests, sure enough, show my cholesterol and lipid levels have ramped up.

So, I pay somewhat more attention than perhaps the average person to news about cholesterol, including recent headlines about new cholesterol guidelines and how they might affect how statins, such as Lipitor and Zocor, are prescribed.

According to NBC News, the new guidelines will “stress treating the sickest and those at the highest risk of a heart attack or stroke, as opposed to the current, more general emphasis on lowering cholesterol numbers.” NBC said that could mean some people might be able to skip taking the drug altogether. Others, on the other hand, may be put on higher doses.

The important thing, one doctor told the network, is “to get people treated” that “we are less concerned about the destination and more concerned about getting people on the trains and out of the station.” In other words, let’s start treating more people and getting them some benefit.

As NBC noted, while such drugs are very good at reducing cholesterol levels, there are side effects, like any other drug. “In 2012,” NBC noted, “the (FDA) updated labeling on statins to include warnings about confusion and memory loss, elevated blood sugar leading to Type 2 diabetes and muscle weakness.”

While I was born deaf in the left ear and require a hearing aid in the right (due to 14 years of radio broadcasting work), I now wonder if some instances of confusion I thought were based on not hearing things correctly is actually due to having taken statins for more than 15 years.

However, since my very first post-screening doctor said I was a “walking heart attack waiting to happen,” perhaps the drugs have also been keeping me alive beyond my original freshness date. Kind of sobering at only 48.

Statins have always been used in terms of lowering numbers -- LDL or “bad” cholesterol under 200, with the highest at-risk heart attack patients aiming for LDL at 70 or lower.

Doctors talking about the new guidelines told NBC the “good news” is that more people will be treated with statins; the “bad news is more people will experience side effects.”

The new guidelines were created by the American Heart Association and the American College of Cardiology (ACC). While I’d like to think these groups would have American’s best interests in mind, I can’t help wondering what ties either group -- especially the ACC -- might have to the pharmaceutical industry.

I’m not usually that suspicious, but, obviously, this will greatly benefit statin makers in that more people taking their drugs means ... well, more people taking their drugs.

On the other hand, some of the reports I read noted that some people currently on statins might not have to be. Perhaps it will all balance out.

While also reporting on the new guidelines, CNN offered some lifestyle changes people can use to try to keep their cholesterol (and I would venture triglyceride) levels down: lose weight (if necessary); be a picky eater, watching out for saturated fats from red meat and dairy products (instead, go for leaner meats, low-fat dairy products, and olive, peanut and canola oils); get active by exercising 30 minutes per day with doctor’s approval; quit smoking; and lower alcohol consumption.

Luckily, I’m in a fairly normal weight range, have never smoked and haven’t consumed alcohol in decades.

WebMd said the “fundamental shift” with the guidelines is that “people will be advised to take a statin if they already have heart disease, if their bad cholesterol is extremely high ... or if they’re middle aged with Type 2 diabetes.”

The thought is that a lot of folks at risk for heart attacks or stroke -- but not diagnosed -- could be helped by taking statins. I can’t disagree with that. Perhaps the new guidelines are a good idea. Let’s hope so.


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