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New heart health guidelines defended

| Monday, Nov. 18, 2013, 7:06 p.m.

DALLAS — Heart experts who wrote new guidelines for preventing heart attacks and strokes are backing a formula that some doctors say overestimates risk.

Doctors who drafted the advice for the American Heart Association and the American College of Cardiology say that any flaws in the formula are small and should not delay the implementation of the guidelines, which expand how many people should consider taking cholesterol-lowering statin drugs such as Lipitor and Zocor or their generic forms.

The guidelines, announced last week, are a sea change in heart care. Instead of having people aim for a specific cholesterol number as has been done for decades, the new advice relies on a formula using factors such as age and high blood pressure to estimate a patient's risk.

The Heart Association held a news briefing on Monday at its annual conference in Dallas because a New York Times story featured criticism by several prominent cardiologists.

Dr. Paul Ridker and Dr. Nancy Cook of Brigham and Women's Hospital in Boston describe in an opinion piece in the British journal Lancet how they tried the formula on patients in three large, observational clinical trials and found it was way off for the number of heart attacks and strokes those patients actually had.

“The predicted risk is roughly twice as high as the observed risk,” Ridker said.

Some doctors don't like the guidelines for reasons that have nothing to do with the risk formula.

Dr. Daniel Rader of the University of Pennsylvania said the older guidelines made it easier for doctors and patients to determine risk, by relying on cholesterol numbers.

“I do think it was a mistake to move away from targets,” he said.

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