Saturday, February 24, 2018
Editorials

Editorial: Guidelines on statins need review

New medical guidelines from the nation's leading heart associations that challenge the status quo on the use of statins to lower cholesterol deserve a hard second look. The American College of Cardiologists and the American Heart Association should thoroughly review their online risk calculator that was rolled out last week to determine whether the results users get reflect the best science or overstate health risks. A well-intentioned effort to help Americans be more health-conscious loses credibility if its results are skewed.

For years, a statins prescription has been the medical standard for patients with high "bad" LDL cholesterol that can't be controlled by diet or exercise. One in four Americans over 40 years old have a prescription for the drug, which inhibits the production of enzymes necessary for the production of the bad cholesterol that can contribute to plaque in the arteries. But such conventional treatment may be out the window for some patients.

After a five-year review, the new standard eliminated guidance on acceptable bad cholesterol levels. That means it is no longer recommended for doctors to prescribe statins for patients who were only on the drugs to lower their bad cholesterol. The team writing the standard said the data don't exist to determine what level of bad cholesterol is desirable for preventing heart disease — or whether chemically reduced bad cholesterol levels have the same benefit as lower levels that come as a result of better diet and exercise.

But if some patients would no longer be advised to take statins, the more dramatic change under the guidelines is that many more people could be deemed candidates for the drug's use. A new risk calculator produced as part of the recommendations appears to frequently overpredict which individuals have a risk of heart attack in the next 10 years. Critics, including a pair of Harvard Medical School professors, suggest the calculator is inflating by as much as 150 percent an individual's risk of heart attack. They fault the research behind the calculations — medical data from an era when more people smoked, women were significantly less likely to suffer heart attacks than men and people suffered heart attacks and strokes at younger ages.

The upshot, as explained by the New York Times, is a man with a 4 percent risk of a heart attack in the next decade might show up as having an 8 percent risk — putting him well-above the 5 percent threshold where treatment is considered and the 7.5 percent where it is advised. The result could be a powerful prescription he doesn't really need.

The kind of examination of standard medical practice that the heart associations undertook is just the kind of discussion that needs to happen across the medical community as the country seeks to move from fee-based to outcome-based practices. But replacing one standard that led 1 in 4 Americans over 40 to be prescribed a drug with a guideline that potentially even more should receive the drug feels, even to the layperson, like overmedication. The groups have said they will take a second look and they should invite their critics to help them. That's good. Americans' health is at stake.

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Editorial: Improve school security plans with gun controls

Editorial: Improve school security plans with gun controls

Gov. Rick Scott and key members of the Florida Legislature offered ambitious proposals Friday that would plug some holes in the stateís safety net, strengthen school security and spend up to a half-billion dollars in response to last weekís massacre ...
Published: 02/23/18
Editorial: Six proposals for reasonable gun control

Editorial: Six proposals for reasonable gun control

Enough is enough. The mass shooting at Marjory Stoneman Douglas High School has renewed conversations about gun control in Washington and Tallahassee. Young people are demanding action, and there are cracks in the National Rifle Associationís solid w...
Published: 02/23/18
Editorial: The time to act on guns is now

Editorial: The time to act on guns is now

The nationís conversation on guns took an encouraging step this week in three essential places ó South Florida, Tallahassee and Washington ó as survivors, victimsí families and elected leaders searched painfully and sincerely for common ground after ...
Published: 02/22/18

Editorial: FDLE probe of state fair fiasco falls short

It should go without saying that Florida law frowns upon public officials who take freebies from vendors and whose agency throws business to their family. But that wasnít enough to move the Florida Department of Law Enforcement to find that the ex-di...
Published: 02/21/18
Updated: 02/23/18
Editorial: They value guns, not kids

Editorial: They value guns, not kids

They value guns over kidsSix days after 17 were killed at Marjory Stoneman Douglas High by a teen-ager firing an AR-15 semi-automatic rifle, the Florida House refused to even debate a bill banning the sale of assault weapons. The vote, 71 to 36, wasn...
Published: 02/21/18

Editorial: Nursing home rule should be stronger

It shouldnít take months or another tragedy for Florida ó which is hot and full of seniors ó to protect its elderly population from heat stroke in the event of an emergency. Thatís why Gov. Rick Scott had the right idea last year in calling for nursi...
Published: 02/20/18
Updated: 02/23/18
Editorial: Listen to Marjory Stoneman Douglas students demanding change

Editorial: Listen to Marjory Stoneman Douglas students demanding change

Students from Marjory Stoneman Douglas High School are traveling to the state capital today and declaring "never again.íí A prominent Florida Republican fundraiser vows he wonít raise another nickel until his party approves new gun controls. Across F...
Published: 02/19/18

Editorial: No more doubt about Russian meddling in election

The latest indictment by the Justice Department special counsel, Robert Mueller, refutes President Donald Trumpís claims that Russian interference in the 2016 election was a Democratic hoax. The indictment details the lengths Russian conspirators too...
Published: 02/19/18

Another voice: Tips should belong to workers, not their bosses

The Trump administration is under fire for proposing a Labor Department regulation that could result in hotel and restaurant employers dipping into the tips customers leave for their employees, depriving the nationís 14 million hard-working restauran...
Published: 02/18/18
Updated: 02/20/18
Editorial: Trumpís rising deficits and misplaced priorities

Editorial: Trumpís rising deficits and misplaced priorities

Itís not popular in Washington or virtually anywhere else these days to express concern about the rising federal deficit. Congressional Republicans who used to be deficit hawks first voted to cut taxes by $1.5 trillion over the next decade, then rais...
Published: 02/17/18