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Last week, the nation’s leading heart organizations released new set of guidelines for lowering cholesterol, along with an online calculator meant to help doctors assess risks and treatment options. But, in a major embarrassment to the health groups, the calculator appears to greatly overestimate risk, so much so that it could mistakenly suggest that millions more people are candidates for statin drugs.

The apparent problem prompted one leading cardiologist, a past president of the American College of Cardiology, to call on Sunday for a halt to the implementation of the new guidelines. "It’s stunning," said the cardiologist, Dr Steven Nissen, chief of cardiovascular medicine at the Cleveland Clinic. "We need a pause to further evaluate this approach before it is implemented on a widespread basis."

American Doctors Reject New Cholesterol Calculator as Inaccurate

The controversy set off turmoil at the annual meeting of the American Heart Association, which started this weekend in Dallas. After an emergency session on Saturday night, the two organizations that published the guidelines — the American Heart Association and the American College of Cardiology — said that while the calculator was not perfect, it was a major step forward, and that the guidelines already say patients and doctors should discuss treatment options rather than blindly follow a calculator.

Dr Sidney Smith, the executive chairman of the guideline committee, said the associations would examine the flaws found in the calculator and determine if changes were needed. "We need to see if the concerns raised are substantive," he said in a telephone interview on Sunday. "Do there need to be changes?"

The problems were identified by two Harvard Medical School professors whose findings will be published on Tuesday in a commentary in The Lancet.

The professors, Dr Paul M Ridker and Dr Nancy Cook, had pointed out the problems a year earlier when the National Institutes of Health’s National Heart, Lung, and Blood Institute, which originally was developing the guidelines, sent a draft to each professor independently to review.

Source
Times of India
19 November 2013,
by - Gina Kolata

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