Need for individual clinical judgements for wider use of statins: Experts

In November 2013, at its national meeting, the American Heart Association, in collaboration with the American College of Cardiology and the United States National Heart, Lung and Blood Institute, presented and published its new guidelines for the use of statins in the treatment and prevention of heart attacks and strokes.

In their invited editorial, Hennekens and Gelb state that any such guidelines are a necessary, but not sufficient basis for the astute clinical judgment of a clinician for each of his or her patients. They provide guiding principles to aid clinicians to make the best judgment about whether to prescribe a statin after consideration of the totality of evidence, which includes the entire risk profile of the patient as well as the benefits and risks of the drug. They re-emphasize that the totality of randomized evidence indicates that there is no threshold for low density lipoprotein cholesterol below which there are no net benefits of statins. These issues in the treatment and prevention of heart attacks and strokes present new and emerging clinical challenges to healthcare providers to more widely prescribe statins in the treatment and prevention of heart attacks and strokes.

"The evidence indicates clearly that the more widespread and appropriate utilization of statins, as adjuncts, not alternatives to therapeutic lifestyle changes, will yield net benefits in the treatment and prevention of heart attacks and strokes, including among high, medium and low risk patients unwilling or unable to adopt therapeutic lifestyle changes," said Hennekens.