Treating 48 to 67 percent of all U.S. adults aged 40-75 with cholesterol-lowering statins would be cost-effective and could avert more than 160,000 cardiovascular-related incidents, two new studies suggest.
Following more expansive but controversial guidelines issued in 2013 could avert tens of thousands of heart attacks, strokes and deaths, the study researchers say.
Before those guidelines, statins use was prescribed almost exclusively under previous 2004 guidelines based solely on a patient's so-called "bad" cholesterol levels.
The newer guidelines, from the the American Heart Association and the American College of Cardiology, proposed considering a person's weight, age, blood pressure and other factors, including smoking or if the person had diabetes, to predict their chances of a heart attack or stoke.
The new guidelines would increase the number of people taking statins by 8 to 12 million, and attracted criticism from some experts who said it overestimated such risks and would put many more people on a drug they might not need and might not be able to afford.
The aim of the new studies, one by Massachusetts General Hospital and another by Harvard University's T.H. Chan School of Public Health, was to determine the potential impact of the new guidelines.
Both studies were published in the Journal of the American Medical Association.
Both found that people who would fall under the new guidelines had a similar risk of cardiovascular events as the patients who had been prescribed statins under the old guidelines, and that the new guidelines "were associated with greater accuracy and efficiency in identifying increased risk," the Mass General researchers wrote.
The Harvard researchers reported similar conclusions.
"The new cholesterol treatment guidelines have been controversial, so our goal for this study was to use the best available evidence to quantify the trade-offs in health benefits, risks, and costs of expanding statin treatment," says lead author of the Harvard study Ankur Pandya, a professor of health decision science.
The new guidelines "represent good value for money spent on health care," he says.
In 2012, 26 percent of Americans over the age of 40 were taking statins, figures from the U.S. Centers for Disease Control and Prevention show.
An editorial accompanying the published studies in JAMA said the study findings should help settle the debate over statin use as put forward in the 2013 guidelines.
To reduce the incidence of heart attacks and strokes, "there should now be fewer questions about how to treat and in whom," the editorial written by cardiologists Dr. Philip Greenland and Dr. Michael S. Lauer said.
