According to The American Heart Association and The American College of Cardiology, 33 million Americans should now be on statin-type cholesterol-lowering drugs. That means about twice as many people as are currently prescribed these drugs. Using the new guidelines, physicians should be prescribing a statin to roughly 44 percent of men and 22 percent of women. Are you one of them?

Here’s what the heart experts are recommending:

  1. Any adult who has already been diagnosed with heart disease should be on an aggressive statin regimen.
  2. Anyone who has an LDL cholesterol over 190 should also be on “high-intensity” statin therapy.
  3. Anyone between the ages of 40 and 75 who has diabetes should be on moderate-intensity statin treatment.
  4. Anyone who scores more than a 7.5% risk of a heart attack or stroke over the next decade is supposed to be on moderate-to-high intensity statin medication dose.

How do you determine if your 10-year risk of a cardiovascular event reaches the magic 7.5% or higher? The committee that drew up the guidelines created a risk calculator that takes into account sex, age, race, total cholesterol, HDL cholesterol, systolic blood pressure, diabetes, smoking history, and whether you are on treatment for hypertension.

So here’s a test for you. Would a 58-year-old non-smoking white man with a total cholesterol of 200, good HDL cholesterol of 45, systolic blood pressure of 125 and not diabetic require a statin under the new guidelines? Answer: YES! That’s even if he has no evidence of heart disease.

Were the same man to be 55, he would not trigger a statin prescription. Do three years make that much difference? According to the guideline committee, you bet!

Even though there is relatively little good data to support the use of statins in older people, the risk calculator mandates a prescription for senior citizens with seemingly good numbers. Here’s another hypothetical patient:

A non-smoking, non-diabetic 70-year-old African American woman with fabulous numbers: total cholesterol 175, good HDL 90 and a systolic blood pressure of 115 still requires a statin according to the risk calculator.

This wouldn’t trouble us nearly so much if statins were benign drugs with a low likelihood of causing side effects. In recent years we have learned that statins not only cause many people substantial muscle pain and weakness, but they can also cause fatigue, joint pain, digestive upset, headache, cataracts, dizziness, sexual problems, peripheral neuropathy and cognitive dysfunction. To learn more about the dangers of statins and other ways to manage risk factors, we offer Graedons’ Guide to Cholesterol Control & Heart Health.

We were especially alarmed to note that everyone with a diagnosis of diabetes between 40 and 75 years of age will be prescribed a statin under the new guidelines. The problem is that statins can actually trigger diabetes in susceptible people and can make blood sugar control more challenging for some patients. This complication seems to have been ignored by the guideline committee.

So, what are we to make of the new guidelines? Not following the guidelines can get a physician into trouble, so doctors will doubtless feel pressured to write more prescriptions for drugs like atorvastatin, lovastatin and simvastatin. Manufacturers of brand name statins still under patent (Altoprev, Crestor, Livalo) may celebrate and consider more advertising.

We think that before millions more people start taking statins, they should consider whether diet and exercise could accomplish the same goals of preventing heart attacks and strokes. A recent essay in JAMA Internal Medicine (Oct. 28, 2013) pointed out that adhering to a Mediterranean diet can lower post-heart attack risk by 30%: “this is as powerful as the effect of statins, without the adverse effects or costs.”

If you would like to see the new guidelines in their totality and download the CV Risk Calculator to determine whether your doctor is likely to whip out his prescription pad, here is a link.

What do you think of the new guidelines? Share your experience with statins? Would you ask your doctor for a statin prescription if the risk calculator says you are over the 7.5% cutoff? Please add your thoughts below in the comment section. Others will be interested in your opinion.


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  1. Prunie22

    Thank you so much for the great statin debate. I have hereditary high cholesterol, and I have been on every statin for over 15 years that has gradually led me to diabetes. I chose to drop the statins, and now my A1C is normal again. I still live with the brain fog and short term memory loss thanks to statins. I will make healthy choices and continue my 12,000 steps every day until my time is up. I will not be a diabetic so Big Pharma can continue their quest for more money. Also, there needs to be more studies on women and their cardiovascular symptoms; ours seems to be ignored by most cardiologists and emergency rooms which is sad. Keep up the research, Peoples Pharmacy!

  2. Pamela D.

    Whoa–both scary and pathetic that intelligent, educated human beings who are trusted implicitly by the majority of the general public would let themselves get caught up in this debacle. Instead of looking at the broad picture of human health, physicians are allowing themselves to prescribe based on a formula. This wouldn’t have happened with a GP 60 years ago who was an independent thinker. As a 73 year-old woman in good health, I refuse to get caught up in this—something I feel is driven primarily by the drug companies. This is only the tip of the iceberg–we have not heard the end of statins and their potential dangers.

  3. LP

    My doctor for the past 7 years (I am now age 67) has suggested that I take statins as my cholesterol is a little high. However, I have declined to do this due to all of the negatives comments I have read about statins and based on side effects experienced by personal friends. Also, due to the fact that all of my other vital signs are excellent and I feel good.
    I make a point of eating healthy, exercising regularly, controlling my weight, getting adequate sleep, and having regular health check-ups. I feel that if I do those things, that if my card comes up, it is my time to go.

  4. lab

    Statins have changed my father’s life – for the worse. He was prescribed cholesterol medication at 72 (when his level was 195), and within a year he’s gone from active and vital to easily exhausted and old. It makes me so sad.

  5. Noah V.

    My own experience with statins was getting a prescription for lipitor.
    I started taking it and within a few days my wife and I both noticed I couldn’t seem to remember things as well as I could just a few days prior. No pain, or at least none I can remember, but my short time memory was down in flames.
    I immediately ceased taking the stuff and within a day or two I was fine… but it was quite scary. My memory is as good, or at least about as good as I remember it to be, as it ever was. But I feel I had a really close call.
    And I happen to be a person who has taken all sorts of drugs, for all sorts of things, and I have a very high tolerance for just about everything. My body is very good at metabolizing and adjusting so this was a big surprise.

  6. mj

    I took several different cholesterol lowering drugs. My doctor finally settled on Lipitor. I took it for two years then developed intense leg muscle pain. I told my doctor who didn’t seem concerned. I changed doctors and went off the Lipitor and the pain went away. I had also had elevated blood sugar. I don’t take anything now although my current doctor suggested a high dose fish oil such as Lovaza.

  7. David C

    I am glad that you have researched cholesterol. Now, as a cardiologist, I would like to know exactly what a high cholesterol does to cause CV disease. I am not being mean, but after 40 years in the business, I can not find any information to remotely suggest that cholesterol causes problems. Now, I am well aware of an association of high cholesterol with increased cardiac disease, but then 60% of heart attacks have normal cholesterol. But, did you know that statins will lower cholesterol by 40%, but that lowering is not associated with a decrease in CV risk? In fact, the only benefit from statins is in just taking the drug in circumstances associated with increase in CRP (Jupiter trial). Note that this role out of guidelines was associated with the major trademarks of the statins drugs being displayed. That means it is an advertisement.

  8. CAK

    In response to MEH who concluded in his 11-17 comment that “statins are sometimes the realistic choice.” I understand where that’s coming from, but after reading extensively in THE GREAT CHOLESTEROL MYTH, it seems like it’s very seldom an EFFECTIVE choice. And if it CAUSEs other problems like it does for so many people, then what’s the point?
    My spouse and I are in our early 70’s. He was having many mysterious periods of not feeling well on a regular basis. Then we came to believe (much from the guidance of what we learned from PEOPLES PHARMACY and what it lead us to read) that the still-entrenched low-fat eating is not beneficial. We started eating lots of eggs and other saturated fat along with olive oil (but NOT trans-fats), and made sugar and high carb foods our villain instead of cholesterol. Guess what! After eating this way for several months, my spouse was feeling well on a regular basis. We were amazed–and grateful.
    And, yes, it took some doing. But we’re actually ENJOYING what we eat.

  9. Paul R

    The Chinese Red Yeast extract we took made us miserable. But within five days it dropped my cholesterol significantly. Several years later we heard that statins damage heart tissue. After ten years I think it is still new. Will I be required to take this or lose my health insurance? Or will it be used to determine me mentally unfit? Please send me more info on Dr. Georgirene Vladutiu (whom you mentioned in your show) doing genetic research on this.

  10. catherinem

    This business of getting the cholesterol down began with a study many years ago. Study participants who had good cholesterol in the low 200’s lived a normal life span for that time. Study participants with lower numbers lived on average two years longer. Study participants with higher numbers lived less long. I think the name of the study was the Framingham Study. My good was 223, my LDL was below 60. So I got started on statins, and got the muscle aches etc, even when switched. I decided two more years of life feeling miserable from a drug which was only to keep me alive longer made no sense.
    This is true of a number of drugs which are marketed only to “keep you alive longer”.
    I also have IDDM. BP, Kidneys, weight are fine, A1c ranges from 6.4 to 7.4. Some catacarts, minor retinopathy. I am 72, and I do not choose to “stay alive” in order to support pharma. Instead, I pay vet bills for two dogs, walk two miles a day, and eat a modified mediterranean diet because that’s what my mother taught me to eat. And I like it.

  11. abc

    I am 81. I was given Crestor 7 years ago (after taking Lipitor and a couple of others, which hurt). I was told that Crestor would be all right. After 30 days, the pain was unbearable (and having kidney stones all my life, I know what unbearable pain is). It damaged my leg muscles, which have not recuperated/come back. I can walk on flat ground, but need a rail to help pull me up steps.
    I will NEVER take a statin drug again.

  12. MEH

    Kudos to all those who have improved their cardiac profile with lifestyle changes! Treating or avoiding disease with lifestyle changes should always be the preferred method.
    However, what do you think should happen to all those who can’t/won’t modify their diet? I know from personal experience just how difficult it is.
    I see people around me daily whose diets are atrocious even though they have high blood pressure, type II diabetes, pockets of cholesterol under their eyes, and/or full-blown heart disease. With 30% of the U.S. population overweight or obese, SOME kind of intervention beyond recommending a change of diet would seem to be in order. Don’t forget that the U.S. is a country where many believe that they have a right to eat trans fats even if means that someone will eventually have to pry their “goodies” from their cold, dead hands after their final heart attacks. Is it any wonder that many doctors seem to despair of anyone listening to their advice with regard to diet and exercise?
    Statins are sometimes the realistic choice.

  13. Andy M.

    At age 44, I just had a stent placed due to a 97.8% blocked LAD artery. My Dr. immediately prescribed Crestor 20mg along with other drugs. So far, I have no side effects to the medication. My father in law has taken statins for @15 years. He has no side effects that he is aware of.
    Are we the only 2 people who have no side effects from taking statins? It seems like we are from listening to today’s show. I believe the show did a disservice to those people who likely should be taking statins. I agree with the Graedons that item 4 of the guidelines is controversial, but what about the other 3, especially item 1. Do statins do no good?
    People’s Pharmacy response: For people like you, statins can be very helpful. As we stated several times during the show, there is no controversy about statins being appropriate for people with heart disease.
    And it is not true that you and your father-in-law are the only ones without side effects. When statins were initially introduced, doctors were amazed at how “well-tolerated” they were. So the side effects didn’t become apparent until a lot of people started taking them.

  14. Madelynn

    The only risk factors I have for cardiovascular disease are my age (71 yrs) and the fact that my mother dropped dead of a heart attqck at age 74. I eat a heart-healthy diet and get a moderate amount of exercise. The doctor thinks I am doing everything right; but, my total cholesterol is 250 and my LDL is 150. I don’t know what else I can do to lower these figures; but, I will never take statins.

  15. J.H.

    Statins work for me with no noticeable side effects.
    I had cholesterol levels of about 220 with HDL in the 40s. I tried changing my diet and exercising and it didn’t help. I started taking statins in 1997 and my total cholesterol dropped to 170s and HDL rose to the 70s.
    I have had no side effects that I am aware of. I stopped for a year to see if I should continue. I didn’t notice any physical or mental changes but my levels shot right back to where they had been.
    I went back on a statin, my levels returned to the good levels and have been there ever since.

  16. SC

    AC, to clarify, your total cholesterol and total LDL cholesterol are two different things. If your total cholesterol is 200, it is highly unlikely that your LDL is greater than or even close to 190.

  17. Mario L.

    Let me just say how invaluable your program is to me. I listen to you more than my doctor. With regard to statins in the latest medical guidelines, we tend to put a lot emphasis on its side effects that we physically experience, but what about those that we are unaware of or we don’t seem to evaluate, and what about its interaction with other medicines that I am taking, which our sciences are yet to discover?
    This is what is bothering me. I am already skeptical about taking pills for any reason…

  18. Melodae Farley Jeffries

    In 2004, my husband (since deceased) was prescribed Lipitor by his endocrinologist at OSU Medical Center. He’d been diagnosed with Type 1 diabetes and Chronic Lymphatic Leukemia in March 2003. I had changed his diet to one of low glycemic foods, with an occasional treat, and had kept his a1C in a good range. I also added fish oil, a B-Complex and a good multivitamin. His cholesterol came down to an acceptable number. His blood pressure was never high — always low. I had read of the hazards of Lipitor and told him and his endocrinologist that he needed to adjust his diet first. His doctor said that he felt Jim had done all he could there. I told him that I was the one with him every day and there were adjustments that could be made. Jim didn’t take the Lipitor, started taking a walk a day and took two fish oil capsules. Within three months, his levels were all good enough that there was no more talk of statins.
    Jim passed away in May 2007 of squamous cell carcinoma.

  19. Geo

    Some folks just cannot tolerate Statins. I’m 45 and in great shape and figured I could tough out the symptoms. After several major muscle tears, weekly migraines and extreme (mind-blowing) leg cramps I’ve given up on them. It’s a real shame because I probably need them. I was above 300 and got down below 120. The drug companies need to work on this a little more.

  20. Marie

    Thanks so much for this article and the comments.
    I suppose the crazy guidelines will appear here, in Sweden, sooner or later.
    I have not taken any statins nor will I.
    I think it`s essential to read books and patient stories, visit different sites and try to make up your own mind.
    One of the sites that I like to visit is
    Malcolm Kendrick is a doctor/author from Scotland and I often laugh when I read his serious texts.
    I just saw that he has written about the new guidelines.
    The title of the article is:
    “They have now, officially, all gone mad?”

  21. Don

    Perhaps in ten years we will be sitting around watching late night TV and a commercial will pop up. “Do you or someone you know have permanent physcial damage from long term statin use?” “If you do, call 1-800-SUE-THEM for a free telephone consultation!”
    Seriously though, stranger things have happened.

  22. A.L.

    Just saying “No” is not easy for some when the doctor either makes you feel guilty or tries to scare you with the word’s “Your a high risk of dying or being disabled by a stroke.” We all need to take proactive steps educating ourselves in nutrition, exercise,and controlling stress. But we and doctors need to understand for some people poor health can happen even to the best of us.

  23. Hjb

    When I heard the teasers at the beginning of the natl. Newscast about new findings thru a new study on cholesterol, I said to my husband, “finally! The real truth is out on statins. ” my jaw dropped when the opposite followed-the number of people on statins needed to be increased. My doc tried me on most of them. I gave them all a fair chance. After two days on any one of them I had terrible brain fog, difficulty managing stairs, fatigue. Felt like a spectator in my own life. Feared getting behind the wheel that my response time was diminished. Got off, took three to four days to recover.
    I am otherwise healthy, eat mostly a Mediterranean diet. After the last trial, same results, told my doc I conclude that I am statin intolerant. I would rather lead a vibrant life and pray for the best, than be a vegetable with “good numbers.” Every doc should read “the great cholesterol myth” by Dr. Sinatra and Jonny Bowden. Dr. Agatston “The south Beach Diet” is of the same mindset.
    The pharma mafia is all about the bottom line. It doesn’t matter how they get there. I am a geriatric nurse. I often wonder if the seniors that are my charges would benefit from discontinuing at least statins. Problem is that these poor souls docs often times do not reevaluate the list of meds that a particular resident is on. Status quo seems to be the norm.
    My husband is type 2 diabetic, has liver issues from Vietnam. Statins will never be on his radar, as long as I am alive. My dietitian daughter is starting to be of the same mindset as her mother. It’s too bad that money has been the driving force of pharmaceutical companies.
    In the end, the hippocratic oath says do no harm. In that vain, docs need to do more research before jumping on the bandwagon. Since they may not have the time, we need to do our own research, print it and give to our docs-the “cliffs’s notes”.
    I think my doc thinks I am nuts. I DO get fired up about these type of things. Cholesterol research has been my obsession. I am now using amaranth as a snack. I also started using the elixir comprised of apple cider vinegar, white grape juice and apple juice. My cholesterol dropped 20 points in six weeks. I am satisfied with these results.

  24. DxC

    I was placed on Statins several years ago and after a few months experienced muscle and nerve problems which stopped my daily walking. Also developed memory problems attributed to the statin. Now, with a new doctor, I was prescribed a newer statin again with the promise it was a better drug. After 3 to 4 days on the drug my leg muscles became weak, my back muscles froze up during walking and I stopped them immediately. Several days later I’m now back to feeling really good. Why don’t doctors listen to us?

  25. STG

    You said it perfectly:”leave me alone!” And just say “NO.”

  26. Jean l.

    This is the reason I have not been to a doctor in about 8 years. Doing fine. By the way the warning given on TV and in other places that their advice is not as good as a doctor’s treatment is mandated by the FDA or AMA or other medical beauracrcy (at least I think I am right on this, not sure). Maybe People’s Pharmacy will correct me if this is wrong. If you have a good doctor you are lucky. Many are just interested in the money. Not all.

  27. liddell

    1)high blood cholesterol levels are indicative, not causative.
    2) statins have very serious side effects.
    3) better ways are easily and cheaply available to “lower cholesterol” by treating the cause. healthy diet, free of irritants and toxins, like chlorine, bromine, gluten or dairy possibly, and noise; and rich in garlic and other heart-healthy herbs and foods, good oils, laughter, sleep, yoga, peaceful mealtimes, enough iodine and other trace minerals, and vitamin D… and so many other good “lifestyle” changes that benefit every cell of the body, and our emotions too.
    Again as always, all the gratitude and respect in the world to the Graedons.

  28. M. B.

    Please, if you can, find out who provides the funding for the doctors who are recommending this. There was not any disclosure regarding funding for these people, their department(s), university, or agency. As you know, this is important information; goes to credibility.
    I am a 67 year old female, cholesterol consistently between 200 and 240 although I am careful with my diet and exercise regularly. Many years ago when a doctor (in the U.S.) tried to put me on statins, I got a second opinion (from a doctor abroad). He said that in the U.S. statins are overprescribed.
    Apparently there are five things that should be considered before putting a person on statins. The best I can remember is: 1) cholesterol number, 2) weight, 3) smoker or non, 4) exercise or not, 5) diet. He said that since only ONE of these five factors applied to me, I should not be on any drugs for cholesterol. Other than that number, I am in good health, and only take vitamins, no meds of any kind. As per many other comments, it appears to be all about the money, not about health.

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