To prevent heart attacks, doctors are trying a new genetic test
Despite the high hopes for the new tests, there are many questions.
Some critics say it’s misplaced to focus on treating younger people, who may not be on a statin or other drug for the rest of their lives. It can be difficult for young people to focus on potential threats to their health in the future, and some of Dr. Rader’s patients have even put off doing polygenic risk testing after he recommended it.
The real need, according to these critics, is among the large group of older people who need cholesterol-lowering treatment but are not receiving it or who are giving up their prescriptions. In one study, about 40 percent of people age 65 and older who had a heart attack and needed lipid-lowering drugs for the rest of their lives stopped taking statins within two years.
Others, like Dr. Rita F. Redberg, a cardiologist at the University of California, San Francisco, editor of JAMA Internal Medicine and a critic of statin overuse, worries that evaluating polygenic risk may introduce new problems.
“There are many downsides to labeling people with a disease,” she said.
The designation, she added, “inevitably leads to testing and the search for treatment options.” And she said: “Because the person who has now become a ‘patient’ is asymptomatic, further testing and possible treatments will be identified in most cases not make the person feel better.”
People can go from thinking they’re healthy to thinking they’re someone with a disease. “Now, if you’re feeling the usual aches and pains of life, ask yourself if it’s because of this ‘disease,'” said Dr. Redberg. “And then they might go to the doctor or even the emergency room for things they wouldn’t have done before. And that will also lead to more tests and procedures with the associated risk of damage.”