Debate Continues Around New Cholesterol Calculator As American Heart Association Stands By Its FormulaBy Staff Reporter
In the wake of the American Heart Association's (AHA) controversial cholesterol calculator, which a handful of prominent researchers have criticized for dramatically exaggerating those at risk of high cholesterol, doctors from around the United States have attempted to determine how the formula came out so flawed, while its makers from the AHA have defended it.
One of the primary uses of the calculator was not just to identify at-risk individuals, but to identify candidates for cholesterol-lowering drugs known as statins, The New York Times reported. (Though the calculator does not "prescribe or mandate that people take a drug, just flag people whose heart risks are high enough that they should consider it," according to Philly.com.) According to Web MD, statins effectively reduce cholesterol levels in the blood and can decrease stroke, heart attack, and death from heart disease by as much as 25-35 percent. Like all drugs, statins come with side effects, which may include headache, difficult sleeping, rash, drowsiness, and dizziness, among others. Yet Web MD, even prior to the AHA's new guidelines, estimated that another 15 to 20 million people should be taking the treatment drug.
The AHA calculator over-assessed risk by 75-150 percent, according to an analysis by Harvard Medical School professors, Dr. Paul M. Ridker and Dr. Nancy Cook, The Times reported. That would mean one third of U.S. individual's ages 40-75 would be considered at risk and eligible for statins, according to Philly.com. Under the old guidelines, 15 percent were eligible.
Ridker and Cook said they'd already notified the AHA a year ago of the formula's pitfalls and were miffed to see the same issues. Ridker presented his findings in a closed-door meeting with the AHA again last week, to which the association had little immediate response, according to The Times.
Dr. Michael Blaha, director of clinical research at the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins University, believed the calculator was based off old data (from the 1990s), when there was a larger gap between risks associated with men and women and people developed higher cholesterol at an earlier age, according to The Times.
"I don't think people have a good idea of what needs to be done," Blaha ventured, referring to the controversy that's followed the new formula.
Over the weekend, Dr. Sidney Smith, the executive chairman of the guideline committee, didn't confirm Ridker's reports, but acknowledged that committee members would reassess the formula, The Times reported. "We need to see if the concerns raised are substantive," he said on Sunday. "Do there need to be changes?"
Tuesday, it appeared the AHA was slowly forming a response, claiming the over exaggerations were mostly over exaggerated, according to Philly.com.
"This tool does an excellent job of ranking people," said dean of the Colorado School of Public Health David Goff, who served on the committee along with Smith. "We think we've come up with a good risk instrument."
Goff seemed comfortable with the calculator's tendency to "round up" during his comments to The Times last week.
"We recognize a potential for overestimates, especially at the high end of risk," he said.