Cholesterol guidelines

Not everyone with a heart condition needs to use a statin. Guidelines from the U.S. Preventive Services Task Force, American College of Cardiology and American Heart Association suggest four main groups of people who may be helped by statins:

• People who have one or more cardiovascular disease risk factors and a higher 10-year risk of a heart attack. This group includes people who have diabetes, high cholesterol or high blood pressure, or who smoke and whose 10-year risk of a heart attack is 10% or higher.
• People who already have cardiovascular disease related to hardening of the arteries. This group includes people who have had heart attacks, strokes caused by blockages in a blood vessel, ministrokes, called transient ischemic attacks, blocked arteries in the legs or neck, or prior surgery to open or replace coronary arteries.
• People who have very high LDL ("bad") cholesterol. This group includes adults who have LDL cholesterol levels of 190 mg/dL (4.92 mmol/L) or higher. Many of these patients have a condition called familial hyperlipidemia and are at a significantly higher risk of heart attacks and strokes.
• People who have diabetes. This group includes adults 40 to 75 who have diabetes and an LDL cholesterol level between 70 and 189 mg/dL (1.8 and 4.9 mmol/L), especially if they have evidence of blood vessel disease or other risk factors for heart disease such as high blood pressure or smoking.

The U.S. Preventive Services Task Force recommends low- to moderate-dose statins in adults ages 40 to 75 who have one or more risk factors for heart and blood vessel disease and at least a 10% chance of having a cardiovascular disease event in the next 10 years.