Healthy Living Healthy Living - June 30th
Jun 30, 2024
Dr. Ross Walker discusses risks of over-prescribing statins and the importance of accurate cardiovascular risk assessment. The episode covers topics like bowel cancer treatment, seasonal affective disorder, non-invasive laser therapy for strokes, and challenges of antimicrobial resistance. Humorous banter and light-hearted segments are interspersed throughout the podcast.
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Risk, Not Numbers, Should Guide Statin Use
- Statins should be prescribed based on overall cardiovascular risk, not just cholesterol numbers.
- Over the past 25 years evidence supports risk-based assessment rather than automatic statin use.
Use Comprehensive Risk Calculators First
- Use comprehensive risk calculators that include age, lipids, BP, BMI, kidney function, diabetes and smoking before starting statins.
- Consider more factors like hemoglobin A1C and proteinuria to refine 10-year risk estimates.
Coronary Calcium Dramatically Alters Benefit
- Coronary artery calcium (CAC) scoring powerfully refines statin benefit prediction in 50–75 year olds.
- CAC=0 showed no statin benefit; CAC>100 produced a NNT of ~12 at five years.