Millions More Americans Eligible for Statins under New Guidelines

Nearly 13 million more Americans would be candidates for statin medications to lower cholesterol under the most recent American College of Cardiology-American Heart Association (ACC-AHA) guidelines, according to a new study in the March 19, 2014, online issue of The New England Journal of Medicine.

The guidelines, released in November 2013, expand the criteria for statin use to people with an increased risk of developing heart disease over the next 10 years.

Duke University researcher Michael Pencina, PhD, a biostatistician, and colleagues extrapolated from their analysis of data from over 3,700 individuals, aged 40 to 75 years, surveyed in the National Health and Nutrition Examination Surveys from 2005 to 2010, that the new ACC-AHA guidelines would increase the number of people taking statins from 43.2 million to 56 million if the recommendations were followed.

The majority of the increase in users of statins would occur in patients over age 60. In fact, the new guidelines would make 77% of people over age 60 eligible for statins, compared with the current 48%. Among those aged 40 to 60, there would be only a 3% increase in statin users. Candidates for statins among healthy women in the 60- to 75-year-old age group would increase from 21% to 53%, the study suggests.

“The biggest surprise of the research was the age-dependent split for those affected by the new guidelines,” Pencina said in a statement. “We anticipated that the impact would be age-dependent, but not to the degree observed. The changes for both men and women in the older age groups where huge compared to those between the ages of 40 and 60.”

However, it is important to note that about 1.6 million adults who were previously candidates for statins would no longer be eligible for the medications. These are largely young adults with elevated cholesterol but a low 10-year risk of heart disease, the researchers said.

“Recommendations are just that—recommendations,” Pencina said. “These guidelines correctly call for a thorough discussion between the doctor and patient about the risks and benefits of statins. It’s not like everybody who meets the guidelines should all of a sudden go on statins.”