New guidelines released this week for cholesterol-lowering medicines could mean many more people will be prescribed the statin medicines given to a quarter of Americans over 40.
Those guidelines, released this week by the American Heart Association and the American College of Cardiology, also mean a change in the decades-old practice of patients on statins no longer needing to lower their cholesterol levels to specific numerical targets.
“Right now we don’t have a number that tells people this is what your cholesterol needs to be, according to the new guidelines,” says Dr. Sara Caceres, a family medicine physician who works with Kaiser Permanente to address the specific needs of the Hispanic community.
According to the old guidelines, Caceres says the LDL, or “bad cholesterol,” for someone young and healthy was supposed to be less than 160 and preferably less than 130. For somebody that has risk factors for heart disease, it had to be less than 100.
“The issue with that is that there is no significant evidence as to why those numbers were chosen,” says Caceres. “The evidence showed that the lower the cholesterol, the better. The key is to not get hung up on a number.”
Caceres explains statins _ medications that decrease the production of cholesterol in the liver _ can have a variety of potential side effects, including muscle pain and liver inflammation.
“This is not a mandate, these are guidelines and it’s a decision between you and your doctor,” says Caceres about whether or not taking statins are right for you. “Get the information from the right sources, and you can make your decision.”
The first thing patients should try, she says, is to improve their diet and exercise.
“I’ve seen it work much better than any medication,” says Caceres. “We know for a fact that works the best.”
She explains that statins act on the liver where we produce cholesterol. Our bodies make cholesterol, and we also eat cholesterol in foods, like meat.
“Statins don’t do anything to the cholesterol that we eat,” she says. “If you change the way you eat to a plant-based diet, there will be no need to take the medication … The majority of people that have high cholesterol, it’s not genetics, it’s their lifestyle. It’s up to the patient to take care of themselves.”
She’s seen the proof happen in front of her eyes.
“I had a patient whose total cholesterol was 330, and she did a vegan challenge for 21 days, and this lady went from 330 to 175 with no medicine in three weeks _ that shows how powerful diet is,” says Caceres. “There is significant evidence mounting that that’s the way our bodies need to eat.”
It’s hard, she admits, to change one’s lifestyle, but if one is willing to exercise 150 minutes a week (and it can be broken down to 30 minutes, five times a week or 10 minutes every morning, afternoon and evening) _ and eat a whole grain, plant-based diet, it can make all the difference.
“The less meat the better, because plants don’t have cholesterol,” says the doctor, originally from Puerto Rico, who understands it’s especially hard for Latinos to change their highly meat-based diets strongly rooted in their culture. “The problem you see in Latinos is lack of information. There are certainly disparities because of that … it’s not that Latinos don’t care about their health, a lot of times its lack of education and know how. Risks start to decrease with more education.”
Originally published on NBCLatino.com.