Sunday, June 17, 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: Encouraging private citizens to step up on transit

Editorial: Encouraging private citizens to step up on transit

The new grass-roots effort to put a transportation package before Hillsborough County voters in November faces a tough slog. Voters rejected a similar effort in 2010, and another in 2016 by elected officials never made it from the gate. But the lates...
Published: 06/15/18
Editorial: 40 years later, honoring remarkable legacy of Nelson Poynter

Editorial: 40 years later, honoring remarkable legacy of Nelson Poynter

Forty years ago today, Nelson Poynter died. He was the last individual to own this newspaper, and to keep the Times connected to this community, he did something remarkable. He gave it away.In his last years, Mr. Poynter recognized that sooner or lat...
Published: 06/15/18

There was no FBI anti-Trump conspiracy

The Justice Department released Thursday the highly anticipated report on the FBI’s handling of the Hillary Clinton email probe and other sensitive issues in the 2016 election. It is not the report President Donald Trump wanted. But there is enough i...
Published: 06/14/18
Updated: 06/15/18

Voter purge may be legal, but it’s also suppression

The Supreme Court’s ruling last Monday to allow Ohio’s purging of its voter rolls is difficult to dispute legally. While federal law prohibits removing citizens from voter rolls simply because they haven’t voted, Ohio’s purge is slightly different. T...
Published: 06/14/18
Updated: 06/15/18

Editorial: Free rides will serve as a test of whether the streetcar is serious transportation

Who wouldn’t jump at the chance to ride for free?This fall, the TECO Streetcar Line eliminates its $2.50-a-ride-fare, providing the best opportunity yet to see whether the system’s vintage streetcar replicas can serve as a legitimate transportation a...
Published: 06/14/18
Updated: 06/15/18

AT&T and the case for digital innovation

A good way to guarantee you’ll be wrong about something is to predict the future of technology. As in, "One day, we’ll all …" Experts can hazard guesses about artificial intelligence, driverless cars or the death of cable television, but technologica...
Published: 06/14/18
Editorial: State, nonprofits share obligation to help Hillsborough’s foster kids

Editorial: State, nonprofits share obligation to help Hillsborough’s foster kids

The Florida Department of Children and Families has correctly set a quick deadline for Hillsborough County’s main child welfare provider to correct its foster care program. For too long the same story has played out, where troubled teens who need fos...
Published: 06/14/18
Editorial: Educate voters on Amendment 4 and restoring felons’ rights

Editorial: Educate voters on Amendment 4 and restoring felons’ rights

This fall voters will have 13 constitutional amendments to wade through on the ballot, but Amendment 4 should get special focus. It represents a rare opportunity to rectify a grievous provision in the Florida Constitution, which permanently revokes t...
Published: 06/13/18
Updated: 06/14/18
Editorial: How Florida and the Trump administration are tampering with your health care

Editorial: How Florida and the Trump administration are tampering with your health care

The Trump administration just can’t stop sabotaging Americans’ access to health care. Instead of giving up after it failed to persuade Congress to repeal the Affordable Care Act, it continues to quietly undermine the law in ways that would reduce acc...
Published: 06/12/18
Updated: 06/15/18

Editorial: Parkland students set example for advocacy

Music is healing. Students from Marjory Stoneman Douglas Senior High School put that theory on display Sunday night in New York with their stirring performance at the Tony Awards — beautifully.The students, all from the school’s drama department, bro...
Published: 06/12/18
Updated: 06/13/18