New Treatment Guidelines Could Put 13 Million Americans on Statin Drugs

Washington, DCRevised guidelines issued by the American Heart Association (AHA) and the American College of Cardiology (ACC) regarding risk factors for heart disease and stroke could put as many as 13 million Americans on statin medications. According to a report by TIME.com the guidelines ease the treatment thresholds to include some 10.4 million people without any history of cardiovascular disease.

When the revised recommendations were made public in November 2013, they came under criticism due to the potential to overtreat people who may not be at significantly greater risk for developing heart disease or cardiac problems.

Now, researchers at Duke University have calculated exactly how many more people may be advised to take statins under the new AHA-ACC recommendations.

“According to the data, which was based on heart disease risk factors and heart disease rates among 3,773 people in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2010, 56 million Americans between the ages of 40 years and 75 years would be eligible for statins, compared to 43.2 million under the older recommendations -- an increase of nearly 13 million,” Time.com reports.

The new guidelines include criteria that are less specific to plaque buildup in the heart arteries that can lead to heart attacks. The Duke researchers state in their study, reported in the New England Journal of Medicine, that most of the new prescription data used to develop the guidelines are from older populations, people between 60 and 75 years of age.

The researchers calculated how many additional lives would be saved by putting people without heart disease on statins, and determined they could prevent 475,000 heart events.

Statins work to lower cholesterol levels and there are a number of them on the market, specifically atorvastatin (Lipitor), lovastatin (Mevacor, Altocor), fluvastatin (Lescol), and simvastatin (Zocor)]. According to a meta-analysis published in the Journal of the American Medical Association in June 2011, data indicate that taking statin drugs is associated with an increased risk for developing diabetes. Statins are among the most widely prescribed drugs used in the management of high cholesterol.

The meta-analysis looked at data from 32,000 study participants in five separate clinical trials, and found that the higher the dosage of the statin drug being taken the greater the risk for diabetes. The risk for diabetes associated with statins seems to come from elevated insulin levels produced by the drug, and other scientific studies have found similar results, with increases in fasting glucose levels.

In 2010 a separate meta-analysis published in The Lancet showed statin therapy was associated with a nine percent increased risk for incident diabetes. Similarly, The Journal of Investigative Medicine published a study done in 2009 that showed that statin use was associated with a rise of fasting plasma glucose in patients with and without diabetes, independently of other factors such as age.