On Tuesday, November 12th, the American Heart Association and the American College of Cardiology jointly published prevention guidelines. The guidelines focus on the treatment of blood cholesterol to reduce heart disease, lifestyle management to reduce heart disease, overweight/obesity management, and cardiovascular risk assessment. These new guidelines call for a focus on risk factors and not just cholesterol levels.
Up until now, the focus has been on “bad” cholesterol — LDL cholesterol — levels and the need to keep LDL cholesterol below 100 mg/dL. Instead of using LDL cholesterol levels to determine if cholesterol lowering statin drugs should be prescribed, the new guidelines look at risk factors.
Here are four questions used to assess risk:
- Do you have heart disease?
- Do you have diabetes (Type 1 or Type 2)?
- Do you have a bad cholesterol level greater than 190 mg/dl?
- Is your 10-year risk of a arteriosclerotic/atherosclerotic cardiovascular disease (ASCVD) event greater than 7.5%?
Base on the new guidelines, if your answer was “yes”, to any of the above four questions, you should be prescribed a statin medication. If you answered “no” to all, then lifestyle and behavior modification should be adequate to manage high cholesterol.
How do you know if your 10-year risk of a ASCVD event is greater than 7.5%? Continue reading

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