Using age- and sex-specific risk thresholds to guide statin therapy: one size may not fit all

New cholesterol guidelines emphasize 10-year risk of cardiovascular disease (CVD) to identify adults eligible for statin therapy as primary prevention. Whether these CVD risk thresholds should be individualized by age and sex has not been explored. This study evaluated the potential impact of incorporating age- and sex-specific CVD risk thresholds into current cholesterol guidelines. Using data from the Framingham Offspring Study, this study assessed current treatment recommendations among age- and sex-specific groups in 3,685 participants free of CVD. Then, it evaluated how varying age- and sex-specific 10-year CVD risk thresholds for statin treatment affect the sensitivity and specificity for incident 10-year CVD events. Basing statin therapy recommendations on a 10-year fixed risk threshold of 7.5% results in lower statin consideration among women than men (63% vs. 33%; p