Patients, Have a Statin Discussion with Your Doctor

By Jane Farrell

Patients and physicians should work together to decide on individualized treatments based on new statin guidelines, according to a commentary by three Mayo Clinic doctors.

The guidelines, issued last year by the American College of Cardiology and the American Heart Association, called for caregivers to prescribe statins to healthy patients if their 10-year cardiovascular risk is 7.5 percent or higher.

“The new cholesterol guidelines are a major improvement from the old ones, which lacked scientific rigor,” says primary author Victor Montori, M.D., Mayo Clinic endocrinologist and lead researcher in the Knowledge and Evaluation Research Unit.

At the same time, Montori says that the threshold of risk contained in the guidelines is a bit arbitrary. To make up for that, he suggests that patients and their clinicians use a decision-making tool to discuss the risks and benefits of treatment with statins.

“Rather than routinely prescribing statins to the millions of adults who have at least a 7.5 percent risk of having a heart attack or stroke within 10 years, there is an opportunity for clinicians and patients to discuss the potential benefits, harm and burdens of statins in order to arrive at a choice that reflects the existing research and the values and context of each patient.”

The commentary was published in the Journal of the American Medical Association (JAMA).