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Low-risk heart patients should help decide when to start statins

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Healthy people with just a 7.5 per cent risk of developing heart disease in 10 years are routinely prescribed a statin drug to lower cholesterol-but it’s a decision they should be taking as equal partners with the doctor, leading physicians are saying.

The risk level for starting drugs is arbitrary and isn’t based on too much science, say three leading physicians at the Mayo Clinic in the US.

As the drugs are powerful and come with harmful side effects, the decision to start treatment should be taken jointly by the patient and doctor.

The 7.5 per cent risk level was set as the ‘best practice’ guideline last year by the American College of Cardiology and the American Heart Association, and attempts to assess the chances of someone suffering a heart attack or a stroke over the next decade.

But a more sophisticated, patient-centred approach is starting to develop, says Victor Montori, an endocrinologist.

(Source: JAMA, 2013; 310: 2503-4)

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