Experts Defend New Heart Attack Prevention Advice


Heart experts who wrote new guidelines for preventing heart attacks and strokes are defending to some doctors that makes overestimate risk for certain groups. Doctors who drafted the new advice for the American Heart Association and the American College of Cardiology say that any flaws in the formulation are small and should not delay the implementation of the guidelines.

The guidelines, announced last week, are a sea change in heart care. Instead of having people aim for a specific number as cholesterol has been done for decades, the new advice relies on a formulation using factors such as age and high blood pressure to estimate a patient’s risk.

Under the new advice, one-third of US adults ages 40 to 75 would meet the threshold to consider taking statin. Under the current guidelines, statins are recommended for only acerca 15% of this group.

The Heart Association held news briefing on Monday at its annual conference in Dallas after a New York Times story published critic reaction by several prominent cardiologists.

Dr. Paul Ridker and Dr. Nancy Cook of Brigham and Women’s Hospital in Boston described in a review piece in British journal ‘Lancet’ how they tried the formulated on patients in three large, observational clinical trials and found it was way off for the number of heart attacks and strokes those patients actually had.

‘The predicted risk is roughly twice as high as the observed risk,’ Ridker said.

However, doctors involved in the guidelines said one reason there were so few of those health problems is that the patients in those studies were prescribed statins to lower their risk. And the groups in the studies cited Ridker were much healthier than Americans in general.

‘This tool does an excellent job of ranking people,’ Dr. David Goff, dean of the Colorado School of Public Health, said of the risk formulation developed his panel.

Dr. Sidney C. Smith Jr, a former Heart Association president from the University of North Carolina at Chapel Hill, said dozens of heart experts spent nearly five years carefully reviewing top-quality studies to develop the guidelines and the formulation and let other major medical groups review it before adopting it.

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