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Tags: seniors | cholesterol | statins | overprescribed

Too Many Seniors Prescribed Statins: Duke

By    |   Thursday, 12 March 2015 04:00 PM EDT

New one-size-fits-all guidelines for the use of cholesterol-lowering statins are pushing doctors to over-prescribe the meds in seniors, according to a new Duke University study.

The researchers also suggested small adjustments to guidelines could enable doctors to catch more people between the ages of 40 to 55 with premature heart disease who could benefit from statins — and prevent unnecessary medication for adults over age 65.
“The recommendations appear to be one-size-fits-all for patients in a variety of groups," said Duke biostatistician Michael Pencina, who helped lead the research published in the Journal of the American College of Cardiology.
"We were interested in how tailoring the guidelines could get beneficial treatment to those who really need it, and avoid over-treating patients whose risk may only be their sex and age."
The guidelines have been challenged since the American Heart Association and American College of Cardiology issued them in 2013. The recommendations have resulted in 13 million new people being recommended for treatment, including most adults over 60.
The guidelines calculate a person's risk of developing heart disease based on their age, sex, race, cholesterol and blood pressure, and whether they've been treated for high blood pressure or smoke.
But after applying the new guidelines to 3,685 people who were part of the long-running Framingham Heart Study, researchers found doctors relying on the guidelines would miss more than half of participants ages 40 to 55 who ended up with heart disease who might have benefited from statins.
At the same time, the guidelines would have over-recommended statins for adults over 60, a large portion of whom continued to be tracked and didn't develop heart disease in the following 10 years.
“The guidelines don't perform particularly well in younger people," said Ann Marie Navar-Boggan, M.D., a cardiology fellow at Duke and a co-researcher. “Lowering the treatment threshold for patients ages 40 to 55 … could capture more middle-aged adults who develop heart disease early [and] raising that threshold [for seniors] could identify the same proportion of men who will go on to have heart disease, but would reduce treatment for those who will not.
“This would help eliminate unnecessary drug treatment for many patients."

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New one-size-fits-all cholesterol guidelines are pushing doctors to over-prescribe statins in seniors, according to a new Duke University study.
seniors, cholesterol, statins, overprescribed
Thursday, 12 March 2015 04:00 PM
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