Mayo Clinic Updates Cholesterol Guidelines

Cholesterol and cardiovascular risk treatment guidelines challenge some common clinical practices

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) The Mayo Clinic recently assembled a task force to update existing cholesterol guidelines.

Many doctors use treatment guidelines that were most recently updated in 2013 to diagnose and treat high cholesterol.

An eye on responding to those guidelines, the Mayo Clinic put together a task force of cardiologists, endocrinologists and preventive medicine specialists to conduct a revision.

"Talk to your cardiologist about a heart-healthy diet."

The guidelines update was conducted by Francisco Lopez-Jimenez, MD, task force chairman and director of preventive cardiology at the Mayo Clinic in Rochester, MN, and colleagues.

Some of the team’s findings challenged guidelines adopted by the American College of Cardiology (ACC) and the American Heart Association (AHA).

The guidelines focus on heart health as it relates to cholesterol. Cholesterol is a fatty substance that builds up in the blood and can stick to blood vessel walls.

Too much cholesterol can increase the risk of heart disease and associated conditions like heart attack.

Statins are a type of prescription medicine used to lower cholesterol. Statins are sold under brand names like Lipitor, Lescol, Mevacor, Crestor and Zocor.

For instance, the existing treatment guidelines recommended high doses of statins to most men older than 65, including in those with no history of heart disease or any major risk factors and normal cholesterol.

The Mayo Clinic task force found “no evidence from clinical trials to recommend treating people only on the basis of age in the absence of risk factors, high cholesterol or inflammation,” according to a press release.

The old guidelines called for treatment with statins as the main preventive measure against heart disease. Healthy lifestyle habits were also encouraged — but secondary to statins.

The Mayo Clinic suggested placing the main emphasis on exercise and dietary changes, followed by “re-evaluating risk in three to six months before prescribing statins,” according to the press release.

The ACC/AHA guidelines recommended statins for all patients with diabetes older than 40.

Contrary to that, the Mayo Clinic task force debunked the idea that patients with diabetes have the same risk as those with a history of heart attacks.

For diabetic patients, the Mayo Clinic task force called for considering statins on a case-by-case basis.

"The ACC/AHA cholesterol guideline was last updated in 2001, so it needed to be updated,” Dr. Lopez-Jimenez said in a press statement. “We agree with many points of the guideline, but there are some key areas where we do not completely agree or we wanted to expand and provide more guidance."

The task force's response to the updated guidelines was published online Aug. 14 in the peer-reviewed journal Mayo Clinic Proceedings.

The authors did not disclose any conflicts of interest.

Review Date: 
August 13, 2014
Last Updated:
August 15, 2014