For Heart Health, Focus on Risk Factors
Treating multiple factors that contribute to heart attack risk is better than simply focusing on lowering a patient’s cholesterol level, according to U.S. researchers.
“We’ve been worrying too much about people’s cholesterol level and not enough about their overall risk of heart disease,” Dr. Rodney A. Hayward, director of the Veterans Affairs Center for Health Services Research and Development, and a professor of internal medicine at the University of Michigan Medical School, said in a news release.
Levels of harmful LDL cholesterol should be less than 130 for most people and less than 70 for high-risk patients, according to the National Cholesterol Education Program.
In their study, Hayward and his colleagues analyzed data from Americans, aged 30 to 75, with no history of heart attack, who took part in clinical trials of cholesterol-lowering statin drugs. The researchers evaluated the benefit of five years of treatment tailored to a patient’s overall heart attack risk based on factors such as age, family history, diabetes, high blood pressure, smoking status and C-reactive protein level.
The results showed that the tailored treatment was more efficient (more benefit per person treated) and prevented substantially more heart attacks, strokes and cardiovascular deaths than simply reducing cholesterol to a certain target. The tailored treatment saved 500,000 more quality-adjusted life years than cholesterol-focused therapy, the researchers said.
“The bottom line message — knowing your overall heart attack risk is more important than knowing your cholesterol level. If your overall risk is elevated, you should probably be on a statin regardless of what your cholesterol is, and if your risk is very high, [you] should probably be on a high dose of statin,” Hayward said in the news release.
“However, if your LDL cholesterol is high, but your overall cardiac risk is low, taking a statin does not make sense for you. If your cholesterol is your only risk factor and you’re younger, you should work on diet and exercise,” he added.
The study was published online Jan. 18 in the Annals of Internal Medicine.
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