Its position will likely have major implications for public-health policy -- and for relentlessly rising health-care costs. A recent study found that about 40 million Americans already take statins on a regular basis, with an estimated cost of
The task force issued its guidelines as doctors continue to disagree about whether statins are appropriate for low-risk patients who have not suffered any consequences of arteries narrowing over time due to waxy cholesterol buildup in the body's main blood vessels.
Statins block an enzyme that allows the body to naturally produce cholesterol. Normally, cholesterol is a building block of human tissue and helps create critically needed hormones. But too much of it can lead to heart disease, which kills an estimated 610,000 Americans each year.
The task force examined the results of six randomized clinical trials to reach its conclusion that giving statins to people as a preventive measure can help reduce the death toll.
"Altogether, the research showed that low-to-moderate-potency statins can help prevent heart attack, stroke or even death," said Dr.
Some physicians refuse to accept the task force's analysis of risks versus rewards.
Redberg said for people who have not suffered such an incident, she does not see the same level of certainty that taking statins would deliver a large enough benefit to justify risking side effects such as developing Type 2 diabetes, memory loss and muscle damage.
She noted the task force's accompanying evidence report on statins, which found that one death was averted for every 233 low- to moderate-risk patients who took statins.
"Everyone agrees that there is a very small chance that any particular person taking statins for primary prevention will actually have any provable benefit," Redberg said.
"This recommendation, if it is fully implemented, would have something like 10 million more Americans taking statins regularly. There is no evidence to support this extremely broad recommendation," Topol said. "I really think they were out of bounds to go to this extreme."
The task force is not backing away from its statin guidelines.
"The risks that some people cite are, in my reading, totally overblown," Greenland said.
Redberg countered that the
"The benefits look a lot more significant when you include high-risk groups," she said, adding that many experts believe most of the statin studies performed to date have not analyzed the potential side effects as aggressively as they have the possible benefits.
The statin-related development of Type 2 diabetes is another area where physicians differ sharply. One side insists the risk is very low, while the other brings up studies that indicate heightened risk, especially for women.
"The research shows no increased risk of diabetes for either men or women in the six randomized, controlled [clinical] trials that were reviewed in the [task force's] evidence report," said Owens at
Topol said he sees patients every day who convince him otherwise.
"I have so many patients in my clinic who came in with a high glucose level and were already diabetic or nearly there. When we get them off the statins, their glucose numbers go right down," he said.
What, then, is a patient to do amid this community of well-intentioned heart experts arguing for diametrically opposed positions?
"I would recommend that [people first] do the other things that have been shown to confer benefit for preventing cardiovascular disease," Golomb said.
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