WCM-Q experts call for a global rethink on statin guidelines for older adults

Doha, Qatar: Population health experts at Weill Cornell Medicine Qatar (WCM Q) have published a perspective article, which outlines the need to rethin...

Doha, Qatar: Population health experts at Weill Cornell Medicine-Qatar (WCM-Q) have published a perspective article, which outlines the need to rethink global statin guidelines for older adults in resource-diverse settings.

The paper highlights that guidelines for statin medications – used to control cholesterol levels – are largely based on evidence from high-income countries, where older adults, especially those ≥75 years, are underrepresented in clinical trials. In the context of increased global life expectancy, biological and regional variation in lipid profiles and CVD risk and regional differences in healthcare services, current uniform guidelines for statin use may not be appropriate and should be reviewed in order to improve appropriateness, feasibility, and equity of prevention strategies, the paper argues.

The situation is further complicated by major inconsistencies between US guidelines, which favor pharmacological prevention, and European guidelines, which place more emphasis on lifestyle and higher-risk thresholds to control cholesterol levels.

The paper, published in the Journal of Global Health, is authored by Dr. Karima Chaabna, manager of population health research; Dr. Sohaila Cheema, associate professor of clinical population health sciences assistant dean for the institute for population health; and Dr. Ravinder Mamtani, professor of population health sciences, professor of medicine (Centre for Global Health), and vice dean for population health and lifestyle medicine. All are members of WCM-Q’s Institute for Population Health, a specialist unit dedicated to advancing population health in Qatar and across the global through education, research and community engagement.

Dr. Mamtani, said: “Statins are widely prescribed and are proven to be effective at reducing the risk of heart attacks and strokes by reducing total and low-density lipoprotein (LDL) cholesterol levels. In the paper we emphasise, that a one-size-fits-all approach for prescribing statins is suboptimal on a global basis because it fails to account for biological and regional diversities, and healthcare resource limitations, particularly in low- and middle-income countries. We believe there is a need to review guidelines on statin use on a regional, context-specific basis in order to secure the best long-term outcomes for patients across the globe.”