Abandoning the Numbers Game

I have written about the flaws behind striving for numeric targets in cholesterol treatment, first in 2008 and again in 2010. Today the American College of Cardiology and the American Hart Association issued joint guidelines that do away with numeric targets and instead recommend more individualized dosing of statins according to the need for their proven cardiovascular risk-reducing effects.

Tonight, the news media are full of comments on the new guidelines. Some writers worry that the more complex guidelines will not be easily accepted by patients or doctors. Maybe the opposite will happen; maybe this will bring a welcome sense of relief that we won’t be penalized if we use some judgement and consider individual risk more in-depth before chosing to treat with a statin.

The numbers game has led to silly treatment decisions and has paved the way for useless polypharmacy instead of appropriate use of statins. Remember, statins do more than lower cholesterol, but since we cannot easily measure the other effects, we have been focusing too much on the one effect we are able to measure.

Via NPR: http://www.npr.org/blogs/health/2013/11/12/244815077/a-shift-in-cholesterol-advice-could-double-statin-use