Morning Rounds: When should doctors prescribe statins for cholesterol?

CBS News chief medical correspondent Dr. Jon LaPook and CBS News contributor Dr. Holly Phillips joined "CBS This Morning: Saturday" to discuss the major medical stories of the week.


There are controversial new guidelines for preventing heart disease that could be a major change in the way doctors prescribe cholesterol medication for millions of Americans. The guidelines say there's no magic number for cholesterol levels when it comes to heart disease prevention. Doctors are now advised to prescribe either a moderate or high dose of statins depending upon patients' risk factors for cardiovascular disease.

This is a drastic change for some patients and shifts away from medication to a focus on a healthy lifestyle. LaPook told the "CBS This Morning: Saturday" co-hosts that the reason they made these sweeping changes is that there was so much "confusion" over the issue.

"Basically the panel is saying there's two groups: the people at high risk of heart disease and stroke and those people at low risk. If you're at high risk, it may be worth it to take a statin because you're going to significantly decrease that risk," he said. "But if you're already starting off at a very low risk, you could take a statin, but it's only going to lower your risk a little bit more, so it may not be worth it to take the statin for decades."

LaPook said that the "bottom line in all of this" is the importance of considering a healthy lifestyle.

"They're specifically talking about the person, for example, who is bragging about their LDL - their bad cholesterol - of 70, very low, but they're obese, they're not exercising, they're eating potato chips," he said. "They're smoking, maybe they have high blood pressure, and they think - falsely - that they're protected, and they're really fooling themselves because they're an accident waiting to happen."

Also this week, a research team at Beth Israel Deaconess Medical Center in Boston examined data from more than a million hospital admissions across the country. They report that more than half of all non-surgical patients are prescribed narcotic painkillers in the hospital, often in very high doses. And many of those patients were still getting these medications on the day they went home.

LaPook said that he thinks this is because doctors are not being educated well enough on how to handle chronic pain. They do not always have to prescribe narcotics.

"There are other things; there's alternative medicine, integrative medicines," he said. "There's massage. There's acupuncture, and there are pain control services now - a lot of hospitals have these - that talk about all the different modalities."

Phillips told the co-hosts that hospital patients and their families need to understand what they are being prescribed.

"One of the main things is to ask. If you're in the hospital and you're experiencing no pain or even if you're feeling a little sedated or groggy, ask," she said. "'Am I being given pain medicine? How much? ... Do I really need it?'"

She said patients who are discharged with medications need to make sure they are only taking those as needed.

"You do not need to follow the bottle, which says two every four hours," she said. "Only take it as you feel pain."

For Dr. Jon LaPook and Dr. Holly Phillips' full roundup on this week's medical stories, watch the video in the player above.

  • Shoshana Davis

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