Two leading heart groups have announced changes being described as "tectonic" and "profound" in the way doctors prescribe cholesterol-lowering statins. The shift from the American Heart Association and the American College of Cardiology means that doctors will no longer focus on a patent's level of "bad cholesterol"—or LDL— and automatically prescribe statins when it reaches a certain level. Instead, they will focus on a range of overall health factors. "This is an enormous shift in policy as it relates to who should be treated for high levels of cholesterol," the chief of cardiovascular medicine at the Cleveland Clinic tells CNN. "For many years, the goal was to get the 'bad' cholesterol levels—or LDL levels—below 100," says Dr. Steven Nissen. "Those targets have been completely eliminated in the new guidelines, and the threshold for treatment has been eliminated."
So who will be taking statins? People who have a history of heart trouble or diabetes, and—in the one exception to the notion of ignoring LDL levels—those who have dangerously high levels of 190 or more, reports the New York Times. Beyond that, the guidelines say anyone who has a 7.5% risk of developing heart disease, based on a new formula (the site is slow, apparently bogged down) also should take them, reports USA Today. In yet another major shift, the guidelines now apply to people at risk of stroke as well as a heart attack, reports AP. That change alone could double the number of people on the drugs, which are currently prescribed to 25% of Americans older than 40.