The American Heart Association and American College of Cardiology released new cholesterol guidelines for treating high cholesterol and risk factors of heart disease in adults. The updated recommendations have outraged some and prompted a public discussion about the safety of statins and the need for cholesterol drugs for those who are at risk of a cardiovascular event or stroke.

Who Should Take Statins?

The new cholesterol guidelines proposed by these organizations encourage the expanded use of statins, cholesterol lowering drugs, to prevent a heart disease or stroke. Previously, the existence of high LDL cholesterol was a precursor for any of the statin recommendations. Now, people with high LDL cholesterol make up just one of four of the target groups.

Any one who falls into one of these four groups is now recommended for moderate or high intensity statin therapy:

– Patients who have cardiovascular disease 
– Patients with an LDL, or “bad” cholesterol level of 190 mg/dL or higher
– Patients with Type 2 diabetes who are between 40 and 75 years of age
– Patients with an estimated 10-year risk of cardiovascular disease of 7.5 percent or higher who are between 40 and 75 years of age

While 10% risk of cardiovascular disease was the previous threshold for statin recommendation, researchers have lowered it to 7.5% in the recently updated release. A formula is provided to help calculate the risk of heart disease in order to determine if you fall into that range. Some are arguing against this newly presented calculator, claiming the formula isn’t accurate and the risk is being overstated.

Public Challenge

Upon reading these new cholesterol guidelines last week, a Harvard clinician and UCSF cardiologist teamed up to challenge the science behind the recommendations in a New York Times op-ed, which claims the calculator overestimates risk and encourages people who have no need for the drug to take statins.

These skeptical health experts claim that the new guidelines benefit the pharmaceutical industry more than any one else and that too many statins are being prescribed without consideration of the potential side effects. According to a previous study conducted by the authors, the over-prescription of statins does not do much to prevent a heart attack in stroke in people, especially in those with a low risk. For people with a low risk, they questioned whether or not statins can actually do more harm than good.

The study found that the drugs can cause cognitive decline, muscle pain or weakness, and an increased risk in diabetes. After numerous reports, the FDA released a cautionary statement in 2012 regarding statins and mental health. Other pro-statin researchers have since come out in an attempt to dispel the results of that study, claiming that statins have no such effect.

Lifestyle Change

Rather than heavily focus on lifestyle, the researchers who created the new cholesterol guidelines simply focused on drug therapy. Though they mention the importance of a heart healthy lifestyle, little is said in that regard. Rather than push more and more people to the lifelong consumption of medication, we should focus on prevention and risk reduction. According to Mayo Clinic, once you begin to take statins, you will likely have to continue taking them for the rest of your life.

Monitoring your cholesterol and risk factors for heart disease and stroke can be simple. Take note of what foods include cholesterol, like meat, cheese, and eggs, and limit your consumption of these foods while working with your doctor. Focus instead on foods like fruits, vegetables, nuts, and other whole foods and incorporate regular exercise as much as you can.

Preventing heart disease shouldn’t involve taking a pill every day, especially if your risk is low. Read more heart healthy tips and begin making changes today that will benefit your health in the future. One last resource that did a really good deep dive into the Cholesterol debate can be found here.