New Data Fuels Doctors’ Demands to Rewrite U.S. Heart Guidelines

Controversial heart disease prevention guidelines that abandoned specific targets for reducing “bad” LDL cholesterol are under fresh assault after a major study highlighted the benefits of taking LDL to very low levels.

Guidelines issued last year by the American Heart Association and the American College of Cardiology asked doctors to assess individual patients’ risk for heart disease over 10 years based on a complex calculation of risks posed by lifestyle, family history and other health conditions. Those deemed at sufficient risk would be prescribed cholesterol-lowering statins.

The recommendation overturned decades of practice in which doctors screened patients for high cholesterol, then sought to reduce LDL to a specific level. Many cardiologists criticized the guidelines, saying they were confusing, and that patients and physicians were comfortable with measurable goals to reduce the risk of heart disease, the world’s No. 1 killer.

Those opponents got a boost from data released on Monday showing high-risk patients fared better when their LDL was brought to very low levels by adding Merck & Co’s Zetia to treatment with a statin.

Several prominent heart specialists told Reuters the guidelines should be changed, with some advocating LDL targets even lower than previous ones. Many have ignored the year-old recommendations.