Scientists have challenged present cholesterol recommendations to lower cholesterol, saying it is important to treat the risk and not just the rise in cholesterol levels.
Experts at the University of Michigan Medical School and VA Ann Arbor Health System found that tailoring treatment to a patient's overall heart attack risk, by considering all their risk factors, such as age, family history, and smoking status, was more effective.
Rodney A. Hayward, director of the Veterans Affairs Center for Health Services Research and Development and a professor of internal medicine at the University of Michigan Medical School, and colleagues discovered that the tailored treatment also used fewer high-dose statins, than current strategies to drive down cholesterol to a certain target.
Hayward said: "We've been worrying too much about people's cholesterol level and not enough about their overall risk of heart disease."
The researchers who worked with Yale University School of Medicine observed that the tailored approach prevented substantially more heart attacks, strokes and cardiovascular deaths than the currently recommended treat-to-target approaches.
The U-M physician said: "The bottom line message - knowing your overall heart attack risk is more important than knowing your cholesterol level. If your overall risk is elevated, you should probably be on a statin regardless of what your cholesterol is and if your risk is very high, should probably be on a high dose of statin.
"However, if your LDL cholesterol is high, but your overall cardiac risk is low, taking a statin does not make sense for you. If your cholesterol is your only risk factor and you're younger, you should work on diet and exercise."
Additional authors who contributed to the study were Harlan M. Krumholz, Yale University School of Medicine, and Donna M. Zulman, Justin W. Timbie, and Sandeep Vijan, M.D, all of the VA Center for Health Services Research and Development, VA Ann Arbor Health Care System.
The findings were to be released online ahead of print in the Annals of Internal Medicine.