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New US lipid lowering guidance comes under fire over “statinisation”

US guidelines on cardiovascular risk assessment – which recommend a statin threshold of 7.5% 10-year CV risk – have come under fire for making a third of the 40-79 CVD-free population eligible for high-intensity statin treatment. A further 13% with a risk between 5% and 7.4% ‘should be considered’ for a statin.


The guidelines – published last month by the American College of Cardiology and American Heart Association – have already been greeted with a barrage of criticism.

An editorial in the Lancet last week claimed the new US risk calculator was seriously flawed, with up to half those identified as statin candidates having a true 10-year risk less than 7.5%.

In the same week a BMJ article stated that eight of the 15 panellists who drew up the guidance had ties to the pharmaceutical industry.

Today an editorial in JAMA weighed in to the fray claiming that the criteria would lead to “statinisation” – massive use of statins at the population level.

The author Dr John Ionnadis of the Stanford Prevention Research Centre says: ‘It is uncertain whether this would be one of the greatest achievements or one of the worst disasters of medical history.’

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