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Age-, Sex-Specific Thresholds Should Guide Statin Therapy

Sensitivity and specificity of recommendations can be improved with use of specific CVD risk thresholds

THURSDAY, April 30, 2015 (HealthDay News) -- Use of age- and sex-specific cardiovascular disease (CVD) risk thresholds could improve the sensitivity and specificity of statin treatment recommendations, according to a study published in the April 28 issue of the Journal of the American College of Cardiology.

Ann Marie Navar-Boggan, M.D., Ph.D., from the Duke University Medical Center in Durham, N.C., and colleagues examined the potential impact of incorporating age- and sex-specific CVD risk thresholds into current cholesterol guidelines. Data were included from the Framingham Offspring Study for 3,685 participants free of CVD.

The researchers found that basing statin recommendations on a 10-year fixed risk threshold of 7.5 percent resulted in lower statin consideration for women (33 percent) than men (63 percent; P < 0.0001); however, stains were recommended for most study participants aged 66 to 75 years (90.3 percent). In younger men and women (aged 40 to 55 years), the fixed 7.5 percent threshold had relatively low sensitivity for capturing 10-year events. When the treatment threshold was reduced to 5 percent in participants aged 40 to 55 years, the sensitivity of the recommendations was improved substantially. Specificity was poor among older adults (aged 66 to 75 years) but it improved significantly when the treatment threshold was raised to 10 percent in women and 15 percent in men, with minimal loss in sensitivity.

"Cholesterol treatment recommendations could be improved by using individualized age- and sex-specific CVD risk thresholds," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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