Cholesterol Lowering Drugs Need to be Used With Caution

[Guest guest]

National cholesterol guidelines that are expected to help more Americans lower their risk of heart disease will boost the number of people eligible for cholesterol-lowering medication by 140%.

Their analysis indicates that the guidelines could triple the number of people younger than 45 who can take medication and increase the number of older Americans eligible for the drugs by about 130%.

The costs of the drugs coupled with a lack of a national drug prescription benefit program could force some older individuals to choose between taking the drugs and buying food.

We have to look at the consequences. There is a large number of people being prescribed very expensive medication and we've had a limited number of years with the drugs.

The guidelines, released last year by the National Cholesterol Education Program (NCEP), a division of the National Institutes of Health, replace those set in 1993. Now, patients with LDL ("bad") cholesterol of 130 milligrams per deciliter (mg/dL) of blood in addition to two risk factors for heart disease are eligible for medication. The previous guidelines set a threshold of 160 mg/dl plus two other risk factors.

People with high cholesterol are at risk of developing heart disease, the leading cause of death in the US. About 500,000 Americans die of heart disease each year. Other risk factors include smoking, excess weight, a sedentary lifestyle and type 2 diabetes.

The updated recommendations stress that diet with exercise is still the first-line of treatment for high cholesterol. But most people will fail to make the lifestyle changes necessary to lower their risk of heart disease and many will turn to the drugs for help.

The more recent recommendations qualify 36 million Americans for drug therapy, of whom nearly one-third are younger than 56, and more than one-quarter are older than 65. About 55% of those eligible are men.

Under the old guidelines, 15 million people aged 20 to 79 were eligible for cholesterol-lowering drugs.

Among other changes, the guidelines now recommend an even lower intake of saturated fat, a higher blood level of HDL ("good") cholesterol and more rigorous testing of fatty substances in the blood