levels of LDL not necessarily with symptoms of cardiovascular diseases; and those between 40 and 75 years old without symptoms of cardiac diseases or diabetes, but with a 7.5 per cent or higher risk of contracting cardiovascular problems within an estimated 10-year period.
Doctors said these four statin benefit groups could lead to a manifold increase in the potential users of these drugs. “Asymptomatic people with moderate cholesterol levels but with a potentially high risk of contracting the diseases have been advised to be put on statins, which in effect increases the (number of) patients. We are talking thousands and thousands of people here,” Dr Upendra Kaul, director of cardiology at Fortis Escorts Hospital in Delhi, said.
He said the entire controversy has stemmed around the last group. “If you are a high-risk individual with a history of cardiac episodes, doctors would recommend statins anyway, as they do have a proven role in reducing the risk of further episodes by 30 to 40 per cent. But if you have moderate levels of LDL and are asymptomatic, I don’t think these drugs should be prescribed at all, definitely not in such sweeping doses,” Dr Kaul said.
He said the guidelines sought to make things easier for cardiologists by advising a “one size fits all” kind of solution, adding that it was “too soon to adopt such easy steps for all patients”. The new guidelines advise against any initial monitoring of levels of LDL, Dr Kaul said.
For people with low and moderate risk of cardiac diseases, Dr Kaul said, “It is still advisable to go by the old thumb rule of monitoring lipid levels since the guidelines are basically asking us to give statins to several people who may not have needed them according to the old guidelines and do it blindly. I think for the moment, we should still be monitoring lipid levels for these people. We have to wait and see how the Europeans, the Canadians and even in the US itself, the guidelines are implemented first.”
Doctors also say that some caution is also advisable because several side effects of statins