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Should you take a statin to prevent a heart attack or stroke?

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New guidelines may expand female candidates for these cholesterol-lowering drugs.

Statins are potent cholesterol-lowering drugs. However, they also have other effects that protect against heart attack and stroke. For that reason, new Guidelines released November 12 from the American College of Cardiology and the American Heart Association have broadened recommendations for use of these medicines. Cholesterol levels no longer are the main factor. As a result, if you’re not taking a statin drug now, you may be advised to start.

The new guidelines provide doctors with a more specific formula for estimating the risk of atherosclerotic cardiovascular disease. It considers your risk not just of a heart attack, but also of a stroke. That could mean some people who now take a statin just to lower their cholesterol may be advised to go off the drug.

Who should take statins?

According to the guidelines, you may be a good candidate for statins if you

  • are at high risk because you’ve had a heart attack, stable or unstable angina, stroke, transient ischemic attack (“mini-stroke”), or a related condition

  • have an LDL (“unhealthy”) cholesterol level of 190 mg/dL or higher

  • have diabetes plus LDL cholesterol of 70 to 189 mg/dL

  • have a 10-year heart disease risk of 7.5% or greater (to learn your risks, visit: my.americanheart.org/cvriskcalculator)

Some critics say the new risk equations may overestimate heart attack and stroke risk. We expect this controversy to be resolved by the time you read this. Another criticism is that the formula may not be as accurate in white women. But many experts say the new guidelines are a step toward more accurate statin prescribing. Because these drugs may cause side effects such as muscle pain and weakness, cataracts, and increased risk of diabetes in women, talk to your doctor about your individual risks, and whether a statin is appropriate for you.

Taking a statin drug shouldn’t replace lifestyle interventions such as eating a heart-healthy diet, exercising, avoiding tobacco products, and staying at a healthy weight. These should still be mainstays of heart disease prevention, in conjunction with medicine.

Posted by: Dr.Health

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