Task force reaffirms guidance for statin use

The U.S. Preventative Services Task Force reaffirmed guidance that doctors prescribe statins to prevent cardiovascular events like heart attacks and stroke.

Why it matters: The new guidelines, published Tuesday in JAMA, reinforce a task force recommendation from 2016.

• They come after the expert panel commissioned a review of additional evidence on the benefits of statins in preventing events like a first heart attack versus the risks posed by heart disease.
• The task force's recommendations influence how primary and preventive care is delivered, along with which services are covered by insurance.

What they're saying: Doctors should continue prescribing a statin to adults ages 40- to 75-years-old who have at least one cardiovascular risk factor such as diabetes, hypertension or smoking, as well as an estimated 10-year cardiovascular disease risk of 10% or greater.

• Doctors may selectively prescribe statins to adults ages 40 to 75 years who have at least one cardiovascular risk factor but who have an estimated 10-year CVD risk of 7.5% to less than 10%.
• People who are older than 75 years old are not included in the task force's recommendation, due to a lack of sufficient evidence.

The big picture: This recommendation comes just more than a month after new risk thresholds dramatically reduced eligibility for statin use in low-risk countries, Medscape reported.

Yes, but: Some clinicians believe the U.S. recommendations aren't broad enough to cover everyone who could benefit from taking the medication.

• They argue that the 10-year guidelines that the task force recommends using will actually keep some people who might benefit from receiving the prescription.
• "Waiting for a person to reach an age when their 10-year predicted (cardiovascular disease) risk exceeds a certain arbitrary threshold before recommending a statin allows atherosclerosis to proceed unchecked for decades," University of Texas Southwestern Medical Center researchers Ann Marie Navar and Eric Peterson wrote in a JAMA editorial.
• The recommendations, Navar and Peterson write, are based on clinical consensus instead of the clinical trial results reviewed by the task force.