For decades, if you asked your doctor what your odds were of suffering a heart attack, the answer would turn on a number: your cholesterol level.
Now the nation’s first new heart disease prevention guidelines in a decade take a very different approach, focusing more broadly on risk and moving away from specific targets for cholesterol.
The guidance offers doctors a new formula for estimating risk that includes age, gender, race and factors such as whether someone smokes.
And for the first time, the guidelines take aim at preventing strokes, not just heart attacks. Partly because of that, they set a lower threshold for using medicines to reduce risk. They recommend using statin drugs such as Lipitor and Zocor, and identify four groups of people they help the most.
The end result: Twice as many Americans — one-third of all adults — would be told to consider taking statins, which lower cholesterol but also reduce heart risks in other ways.
“The emphasis is to try to treat more appropriately,” said Dr. Neil Stone, the Northwestern University doctor who headed the cholesterol guideline panel. “We’re going to give statins to those who are the most likely to benefit.”
Doctors say the new approach will limit how many people are put on statins simply because of a cholesterol number. Yet under the new advice, one-third of U.S. adults — 44 percent of men and 22 percent of women — would meet the threshold to consider taking a statin. Under the current guidelines, statins are recommended for only about 15 percent of adults.