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Last week new guidelines for the treatment of cholesterol were published in the New England Journal of Medicine online. Though the guidelines were released in 2013 by the American College of Cardiology and the American Heart Association, researchers are just now beginning to look at what their impact would be on Americans—and the data is raising some concerns.

A team of analysts led by Michael J. Pencina, Ph.D. of the Duke Clinical Research Institute in North Carolina now estimates that nearly 13 million more U.S. adults may soon be taking statins to treat high cholesterol and prevent heart disease. Here is a quick (and eye-opening) breakdown of the numbers, based on information gathered from more than 3,700 U.S. adults between the ages of 40 and 75:

  • The new guidelines could result in 49 percent of U.S. adults ages 4075 being recommended for statin therapy, an increase from 38 percent.
  • The increase is much more pronounced among adults free of cardiovascular disease who are over age 60, with 77 percent recommended for statin use under the new guidelines vs. 48 percent under the previous standards. This contrasts with a modest increase from 27 percent to 30 percent among U.S. adults between the ages of 40 and 60.
  • Those most affected by the new recommendations are older men who are not on statins and do not have cardiovascular disease. Under the earlier guidelines, about 30.4 percent of this group of men between the ages of 60 and 75 were recommended for statin use. With the new guidelines, 87.4 percent of these men would be candidates for the therapy. Similarly for healthy women in this age group, those recommended for preventive statin use are projected to rise from 21.2 percent to 53.6 percent.i

The new guidelines focus more on risk factors such as smoking and obesity rather than specifically working to lower so-called “bad” cholesterol, but statins are not the only answer. Although beneficial for people who have already had a heart attack or stroke because they help reduce plaque buildup in the blood vessels, the cholesterol-lowering drugs have health risks that should not be ignored—and heart disease prevention should begin instead with important diet and lifestyle changes.

Simple changes such as getting more exercise, optimizing your Omega-3 intake, and eating a diet high in non-starchy vegetables, low-sugar fruits, healthy fats, lean proteins, nuts and seeds can go a long way toward improving your heart health now and in the future.

In response to the new guidelines, cardiologist Rita Redberg of the University of California-San Francisco said, “If our goal is to help people feel better, live longer and have less heart disease, putting millions more on statins is not going to do that.” She emphasized instead the importance of a healthy diet, exercise, and quitting smoking.



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Researchers at Brigham and Women’s Hospital in Boston and the Fred Hutchinson Cancer Research Center in Seattle will soon begin the first large-scale study of its kind to look at whether the beneficial nutrients found in cocoa beans may help prevent heart attacks and strokes.

Instead of candy bars, scientists will be handing out capsules containing 750 mg of cocoa flavanols daily to 18,000 participants (though some will receive a placebo) and keeping track of their heart health over a period of four years. Flavanols are a type of plant nutrient found abundantly in cocoa beans that have been shown to support cardiovascular health in several ways.

“In smaller trials [flavanols have] been shown to reduce blood pressure, improve the cholesterol profile, improve sensitivity to insulin and also help the blood vessels to dilate,” said Dr. JoAnn Manson, chief of the Division of Preventive Medicine at Brigham and Women’s and one of the study’s lead researchers.

Cocoa Powder and Gut Bacteria: The Link to Heart Health
In a similar study, food scientists from Louisiana State University recently discovered the beneficial bacteria in our digestive tracts love chocolate just as much as we do—well, cocoa powder, to be exact.

When our gut microbes consume cocoa powder, they convert it into heart-healthy compounds that support a healthy inflammatory response, protect our blood vessels from stress, and promote healthy arteries. Cocoa powder contains high amounts of antioxidant polyphenols, known to support cardiovascular health and protect against disease.

In addition, by gobbling up the fiber found naturally in cocoa beans and breaking it down into beneficial short-chain fatty acids, gut bacteria help us feel full longer after eating—which in turn promotes healthy weight management.

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