New guidelines urge wider use of cholesterol-lowering drugs to reduce heart attacks, strokes

The nation's first new guidelines in a decade for preventing heart attacks and strokes call for twice as many Americans — one-third of all adults — to consider taking cholesterol-lowering statin drugs.

The guidelines, issued Tuesday by the American Heart Association and American College of Cardiology, are a big change. They offer doctors a new formula for estimating a patient's risk that includes many factors besides a high cholesterol level, the main focus now. The formula includes age, gender, race and factors such as whether someone smokes.

The guidelines for the first time take aim at strokes, not just heart attacks. Partly because of that, they set a lower threshold for using medicines to reduce risk.

The definition of high cholesterol isn't changing, but the treatment goal is. Instead of aiming for a specific number, using whatever drugs get a patient there, the advice stresses statins such as Lipitor and Zocor and identifies four groups of people they help the most.

"The emphasis is to try to treat more appropriately," said Dr. Neil Stone, the Northwestern University doctor who headed the cholesterol guideline panel. "We're going to give statins to those who are the most likely to benefit."

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