New guidelines expand statin eligibility by 13 million

Increase largely driven by eligibility of adults aged 60 years and older without cardiovascular disease in the primary prevention setting.

New guidelines expand statin eligibility by 13 million
New guidelines expand statin eligibility by 13 million

HealthDay News -- New cholesterol guidelines from the the American College of Cardiology (ACC) and the American Heart Association (AHA) will increase the number of Americans aged 40 to 75 years who are eligible for statin therapy to 12.9 million, researchers estimate.

This represents an increase from the 43.2 million eligible under previous guidelines to 56 million under the new guidelines, Michael J. Pencina, PhD, from Duke University in Durham, N.C., and colleagues reported in the New England Journal of Medicine.

The increase will mostly affect individuals aged 60 years and older without cardiovascular disease in the primary prevention setting, the researchers noted.  

They used data from 3,773 individuals ages 40 to 75 who participated in the National Health and Nutrition Examination Surveys (2005 to 2010) to compare the number of persons and the risk-factor profile for persons who would be eligible for statin therapy under the new ACC-AHA guidelines versus those eligible under previous Third Adult Treatment Panel (ATP III) guidelines.

The number of adults aged 60 to 75 years without cardiovascular disease eligible for statin therapy  would increase from 30.4% to 87.4% among men and from 21.2% to 53.6% for women, the researchers found.

The ACC-AHA guidelines would have a higher sensitivity and lower specificity than the ATP-III guidelines in that they would recommend statin therapy for more adults who would be expected to have future cardiovascular events, but include many who would not have future events.

"Since the prevalence of cardiovascular disease rises markedly with age, the large proportions of older adults who would be eligible for statin therapy may be justifiable," the researchers wrote.

About 475,000 cardiovascular events would be prevented using the new guidelines instead of the older ones, assuming full adoption and adherence, they calculated.

References

  1. Pencina M et al. N Engl J Med. 2014; doi: 10.1056/NEJMoa1315665.
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