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Heart disease risk app may increase statin prescriptions

Screenshot of ASCVD Risk CalculatorClinCalc.com

The next time you have a general physical, you might be told to consider taking a cholesterol-lowering statin—even if you never had a heart attack, don’t have diabetes, and don’t even have high cholesterol. That’s thanks to a new app hitting doctors’ iPads and smartphones this month that calculates your 10-year risk of having a heart attack, clogged artery, or stroke.

It was developed by the American College of Cardiology and the American Heart Association, the same folks who issued the new cholesterol treatment guideline that some cardiologists predicted would double the number of Americans taking statins from 36 million to 72 million.

The guideline urges physicians to prescribe statins—such as atorvastatin (Lipitor) and rosuvastatin (Crestor)—to anyone between 40 and 75 years of age whose 10-year risk is 7.5 percent or greater. This is based on a new calculation tool, featured in the new app, which considers age, cholesterol level, blood pressure, race, and a few other factors.

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Two heart researchers from Brigham and Women’s hospital applied the risk-assessment tool to various study populations and published a paper last November calling it inaccurate.

Dr. Roger Blumenthal, director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease who was not involved in the new guideline, tested the app and said it was very “user friendly”. It will also help foster conversations between doctors and patients who are borderline high-risk, in order to help them make an individual decision on statin use—considering, say, family history which is not on the app.

The app does instruct doctors to have a discussion about the risks and benefits of statins and to consider patient preferences; whether busy primary care providers will make the time to have that discussion, rather than simply prescribing the drugs, remains to be seen.

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