February is American Heart Month: do you know your personal 10-year risk of heart disease? And the key factors that elevate heart disease risk?
What’s Your Personal 10-Year Risk of Heart Disease?
You can easily calculate your own 10-year risk of heart disease. In fact, the risk calculator is even available in an app (my cardiologist used his phone to calculate my risk during our last appointment). If you do not already have heart disease, are between 40-80 years old, and have an LDL cholesterol level lower than 190 mg/dL, you can calculate your 10-Year risk of heart disease with an online calculator.
It’s startling how much debate and disagreement exists about the guidelines for statin use.
Back in November 2013, new guidelines were published by the American Heart Association and the American College of Cardiology. The 2013 guidelines represented a significant shift in cholesterol management: essentially moving away from targeting/treating to a specific cholesterol level and instead encouraging treatment of all individuals with a 10-year risk of heart disease of 7.5% or higher (for specifics, see my post, The NEW guidelines for cholesterol-lowering statin meds).
There then ensued heated arguments over the published Risk Calculator that yields that all-important 10-year level of heart disease risk.
The quick answer to ‘Am I a candidate for one of the two new PCSK9 cholesterol-lowering drugs?’ is Probably Not (unless you have FH or have heart disease / have had a heart attack.)
The reason? Two, actually. First, this totally new class of (injectable) cholesterol-lowering drugs is approved ONLY for those with high cardiac risk. And secondly, clinical study results with key safety data won’t be available for YEARS.
The two new drugs, Praluent and Repatha, were approved this past summer by the FDA only for those with a serious, genetically inherited disease that causes very high LDL (bad) cholesterol called Familial Hypercholsterolemia (FH) and/or for those who have heart disease / have suffered a heart attack.
The National Lipid Association (NLA) recently released an ‘infographic’ that, according to the person who contacted me on behalf of the NLA, is intended “to help people better understand their cholesterol to help reduce the risk of heart attack and stroke.”
And indeed, I think it’s a very useful chart. Essentially, it helps you visualize your heart disease risk by turning the major risk factors into a series of easy questions; these questions help determine your heart disease risk and serve as a basis for discussion with your doctor:
You can also find this chart on the National Lipid Association’s “Learn Your Lipid”
The new cholesterol treatment guidelines were unveiled on November 12, 2013 and controversy flared almost immediately.
A duo of doctors are concerned that the new calculator used in one part of the guidelines seriously over-estimates heart disease risk (the calculator delivers a person’s 10-year risk of heart disease: the new guidelines state those with a risk above 7.5% should take a statin). If they are right, the result would be millions of new people taking a statin — who maybe don’t need this drug.
A serious concern, indeed.
Am about to go into a bit of detail about why it might be over-calculating: if you know already/have been following in the news (or don’t care for the details) skip down to BOLD below!