Thursday, April 19, 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: Why single-member districts would be bad for Hillsborough commission

Editorial: Why single-member districts would be bad for Hillsborough commission

Anyone looking to make Hillsborough County government bigger, costlier, more dysfunctional and less of a regional force should love the idea that Commissioner Sandy Murman rolled out this week. She proposes enlarging the seven-member board to nine, e...
Updated: 10 hours ago
Editorial: Improving foster care in Hillsborough

Editorial: Improving foster care in Hillsborough

A new foster care provider in Hillsborough County is poised to take over operations in May, only months after its predecessor was fired for what was alleged to be a pattern of failing to supervise at-risk children in its care. Many of the case manage...
Published: 04/18/18

Another voice: Back to postal reform

President Donald Trump is angry at Amazon for, in his tweeted words, "costing the United States Post Office massive amounts of money for being their Delivery Boy." Yet in more recent days, Trump has at least channeled his feelings in what could prove...
Published: 04/17/18
Updated: 04/18/18
Editorial: Congress should protect independence of special counsel

Editorial: Congress should protect independence of special counsel

A bipartisan Senate bill clarifying that only the attorney general or a high-ranking designee could remove a special prosecutor would send an important message amid President Donald Trump’s attacks on the investigation into Russia’s inter...
Published: 04/16/18
Updated: 04/17/18
Editorial: Don’t fall for Constitution Revision Commission’s tricks

Editorial: Don’t fall for Constitution Revision Commission’s tricks

The Florida Constitution Revision Commission has wasted months as a politically motivated scam masquerading as a high-minded effort to ask voters to improve the state’s fundamental document. The commission on Monday added amendments to the Nove...
Published: 04/16/18
Editorial: Redner’s court win on medical marijuana sends message

Editorial: Redner’s court win on medical marijuana sends message

Florida regulators have done far too little to make voter-approved medical marijuana widely available for patients suffering from chronic illnesses. A circuit court judge in Tallahassee ruled last week there is a price for that obstruction, finding t...
Published: 04/15/18
Updated: 04/16/18
Editorial: Hillsborough commission should quit expanding urban area

Editorial: Hillsborough commission should quit expanding urban area

Any movement on modernizing local transportation is welcome, even small steps like the million dollars the state recently approved to design a Tampa Bay regional transit plan.But the region won’t make any progress on transportation, its single most p...
Published: 04/13/18
Updated: 04/18/18

Editorial: Fight harder on citrus greening

A new report by scientists advising the federal government finds no breakthrough discovery for managing citrus greening, a chronic disease killing Florida’s citrus industry. This should be a wake-up call to bring greater resources to the fight.The re...
Published: 04/11/18
Updated: 04/13/18

Editorial: Floridians should focus more on health

A new snapshot of the nation’s health shows a mixed picture for Florida and the challenges that residents and the health care community face in improving the quality of life.Americans are living longer, exercising more and doing better at managing th...
Published: 04/11/18
Updated: 04/13/18
Editorial: 5 key issues where Scott, Nelson differ in Senate race

Editorial: 5 key issues where Scott, Nelson differ in Senate race

Gov. Rick Scott kicked off his U.S. Senate campaign last week by reciting tired lines about career politicians and mischaracterizing himself as an outsider. That pitch may have worked during the tea party wave eight years ago, but now the Republican ...
Published: 04/10/18
Updated: 04/13/18