by Who is Gavin?, Elaine Vitone
Adapted from a University of Pittsburgh Health Sciences News Release
More than half of adults ages 30 to 79 — about 87.5 million people in the United States — meet criteria to take cholesterol-lowering drugs called statins to prevent future heart attacks, strokes and other problems, a new study projects.
The study assessed the impact of updated clinical guidelines, Issued in Marchwhich expands the merits of statins by recommending assessment of patient cardiovascular risk in future decades and introducing statins at a younger age in high-risk individuals.
The result?
An additional 21.5 million Americans are now recommended for statinsAccording to a new paper by a team from the University of Pittsburgh and the University of Michigan, 57% of the total number of adults aged 30 to 79 is below that.
The team published their results clotheswhich simultaneously published two other studies on the subject and a Summary of guidelines aimed at all health care providers That may play a role in prescribing the appropriate statin.
A editorial The journal noted that even under the older, more conservative guidelines, about half of American adults who could have received preventive benefits from statins did not take them.
Pitt and UM researchers conducted their study using a national database of health data following the March 2026 release of updated guidelines by the American Heart Association, American College of Cardiology and other organizations.
The guidelines include one Updated risk calculator released in 2023 and expanded statin eligibility by extending the age range from 40-75 to 30-79 and the risk horizon from 10 years to 30 years.
“The shift to a longer view of cardiovascular disease risk is a sea change for doctors in counseling patients,” says Timothy S. Anderson, MD, MAS, is a primary care physician, health quality researcher and assistant professor of medicine at Pitt.
“We wanted to better understand the potential population-health implications of these changes.”
He added, “Prior to the new guidelines, people who were flagged with high cholesterol in their 30s and 40s were recommended to focus on diet and exercise, and drugs were not recommended, unless the patient already had heart disease or other factors that put them at particularly high risk, such as diabetes.”
Jeremy Sussman, MD, M.Sc., the study’s senior author and a primary care physician at the VA Ann Arbor Healthcare System who is also an associate professor of internal medicine at the UM Medical School, noted that risk, and therefore eligibility for statins under any guidelines, increases with age.
“According to the new guidelines, about 10% of Americans are recommended in their 30s and 40% in their 40s. When people are in their 50s, that number jumps to about 80%, and for people in their 60s, it’s 85%. And more than 90% of people in their 70s are recommended under the guidelines.”
Sussman, who presided AHA’s Primary Care Science CommitteeNotes that it is important for patients to talk with their physician or other counselor about their eligibility for statins and their concerns.
“Statins have been used in America for more than 40 years, many are very inexpensive, and they have generally proven to be very safe and very effective,” he said.
“Some side effects are possible, but they are not as severe and not as common as we would expect.”
The expansion of new recommended individuals for treatment is driven strongly by patients who are generally at low risk in the short term, meaning their risk of having a heart attack or stroke within 10 years is below 3%, but their risk is greater than 10% within 30 years.
The team analyzed data from 4,366 participants in the National Health and Nutrition Examination Survey from 2017 to 2023, representing 154.5 million US adults without current cardiovascular disease.
The analysis focused specifically on primary prevention — reducing risk before a heart attack or stroke occurs — and did not include pregnant people in the study sample.
Anderson, who was a member of the committee that wrote the new guidelines, acknowledged that they represent a major conceptual shift for patients, as they face the question of whether to start a daily medication now to prevent something from happening more than 10 years down the road.
“Many of my younger patients wonder why they can’t stop treatment when they start—which is understandable, if they have a low risk of a cardiovascular event within 10 years—and some can probably focus strongly on healthy diet, exercise, and weight. But for patients to reduce their risk of heart attack and stroke altogether, early statin therapy may be a better choice.”
Anderson adds that the biology of cardiovascular disease is an evolving story.
“Observational evidence shows that the longer people are exposed to inflammatory cholesterol molecules, the greater their risk of heart attack and stroke. Unfortunately, we haven’t had randomized clinical trials in low-risk people for 30 years that would directly support this new understanding because it’s more expensive and we have to wait more years to establish such risk. Decades for answers,” he said.
“Ultimately, in this gray area, patients should talk to their doctors. It’s a choice-based decision that should consider the potential for adverse drug events, costs, and patient preferences, as well as the potential for modest cardiovascular risk reduction.”
Importantly, Anderson emphasizes, medication is not the only tool in the cardiovascular disease prevention toolkit.
“It’s certainly very reasonable that a lot of people would talk to their doctor about this and say, ‘Okay, what can I do that doesn’t involve medication?’ Physicians have long recommended lifestyle changes such as healthy diet, exercise, and smoking cessation for all their patients, regardless of whether they have high cholesterol—and will continue to do so.”
But given the low use of statins for primary prevention even under the old guidelines, Sussman noted that there are groups of people for whom the recommendations have not changed.
“The most important people to take statins are those with a history of cardiovascular disease, including heart attack, stroke, or any other major heart disease. Others who are always going to be recommended statins are anyone with diabetes, HIV, and chronic kidney disease,” Sussman said.
Statins and lifestyle changes aren’t the only tools to reduce heart attacks and strokes, which are still the first and fifth leading causes of death among Americans, Sussman added.
Medications to lower blood pressure and blood sugar and help with weight management in appropriate patients are also important options.
He recommends the AHA “Eight Essentials of Life” Toolkit for patients as a means of understanding the main factors and interventions that may influence long-term cardiovascular risk.
Sussman is a member of the VA Center for Clinical Management Research and the UM Institute for Healthcare Policy and Innovation.
Linnea M. Wilson, MPH at Beth Israel Deaconess Medical Center and the University of Colorado, is also an author on the paper.
Funding/Disclosure: This research was supported by the National Institute on Aging (K76AG074878).
Paper cited: “Implications of the 2026 Dyslipidemia Guidelines for Primary Prevention Statin Therapy,” clothes. DOI: JAMA.doi:10.1001/jama.2026.11246
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Previously published Also at michiganmedicine.org Creative Commons License
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