Editorial comments on the guidelines
In an accompanying editorial, Rita F. Redberg, MD, MSc, and Mitchell H. Katz, MD, from the Department of Medicine at the University of California in San Francisco, note that clinicians must verify that the medication will lead to a better quality of life, longer life, or both before recommending statin therapy to a patient.
“Given the serious concerns about the harms of the reliance on statins for primary prevention, it is in the interest of public health and the medical community to refocus efforts on promoting a heart healthy diet, regular physical activity, and not smoking,” they noted.
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However, Philip Greenland, MD, and Robert O. Bonow, MD, MS, from the Northwestern University Feinberg School of Medicine in Chicago, Illinois, stated in an additional editorial that every patient older than 40 years of age should be considered for statin therapy.
“All of the guidelines are correct in suggesting that additional trial evidence is needed for older adults, but this will be years in the future. Until such trial evidence is available, it is reasonable to extrapolate data from younger patients to include otherwise healthy individuals older than 75 years, and it is not necessary to stop statin therapy when a 75-year-old turns 76,” they wrote.
“Clinical judgment and patient input are critical components of the decision process, especially for older patients and those at lower risk,” they concluded.
References
- US Preventive Services Task Force. Statin use for the primary prevention of cardiovascular disease in adults: US Preventive Services Task Force recommendation statement. JAMA. 2016;316(19):1997-2007. doi: 10.1001/jama.2016.15450.
- Greenland P, Bonow RO. Interpretation and use of another statin guideline. JAMA.2016. doi: 10.1001/jamacardio.2016.4950.
- Redberg, RF, Katz MH. Statins for primary prevention: The debate is intense, but the data are weak. JAMA Intern Med. 2016. doi: 10.1001/jamainternmed.2016.7585.
