Not everyone wants to take a statin for the rest of their life when their doctor prescribes it. Deposits of calcium in the coronary arteries are a sign of atherosclerosis—a disease in which plaque buildup over time can narrow or block the heart’s arteries. By using the coronary artery calcium (CAC) score that measures the amount of calcium in the walls of these arteries, researchers determined a strategy to taking statins that is cost effective and does not require a one-size fits all approach for African Americans.
Researchers performed an analysis of the 2013 and 2018 ACC/AHA cholesterol guidelines for African Americans who were part of the Jackson Heart Study. Their analysis weighed the tradeoffs of costs, treatment benefits, and treatment harms. The researchers found that the 2018 guidelines, which recommend statins only if patients aged 40 to 75 years of age have coronary calcification as indicated by a CAC score greater than zero, were effective when patients had preference to avoid statin treatment.
The results of the study, published in JAMA Cardiology, found that for patients who were willing to trade two weeks of life lost to avoid a decade of statin therapy, the 2018 guidelines would be optimal because the additional information from the calcium score could change the treatment recommendation. African American patients who have an intermediate risk of atherosclerosis should discuss their treatment preferences with their doctor when making statin treatment decisions. The study was funded by NHLBI.