Extended use could prove risky.

• Position: Statins

New guidelines that could nearly double the number of Americans taking statin drugs to prevent arteriosclerotic cardiovascular disease (ASCVD) are supported by two studies published in The Journal of the American Medical Association. 'The studies should be scrutinized critically," stresses Jane M. Orient, executive director of the Association of American Physicians and Surgeons, Tucson, Ariz. "Putting nearly half the healthy population on a potent drug for 10 years in the hope of protecting perhaps two percent of them from a heart attack or stroke over that time period is risky medicine."

The guidelines released by the American Heart Association, Dallas, Texas, and the American College of Cardiology, Washington, D.C., added the criterion of a 10-year risk of ASCVD exceeding 7.5%. In a JAMA editorial, Philip Greenland, the publication's senior editor, and Michael S. Lauer of ResearchGate, "suggest that the new risk threshold is likely to be reasonable and cost-effective; it may not even go far enough."

The pair maintain that the 7.5% threshold would increase the number of persons eligible for treatment from 43,000,000 to 56,000,000 and theoretically avert...