Regardless of the excessive hopes for the brand new assessments, there are various questions.
Some critics say {that a} deal with treating youthful individuals is misplaced as a result of they could not adjust to taking a statin or one other drug for the remainder of their lives. It may be troublesome for younger individuals to deal with potential threats to their well being many years sooner or later, and a few of Dr. Rader’s sufferers have delay even getting polygenic danger assessments after he recommends them.
The actual want, these critics say, is with the massive group of older individuals who want cholesterol-lowering remedy however aren’t getting it, or who’re abandoning their prescriptions. In a single research, about 40 p.c of individuals 65 and older who had a coronary heart assault and want lipid-lowering medicines for the remainder of their lives cease taking statins inside two years.
Others, like Dr. Rita F. Redberg, a heart specialist on the College of California, San Francisco, the editor at JAMA Inner Drugs and a critic of the overuse of statins, is anxious that polygenic danger scores might introduce new issues.
“There’s quite a lot of draw back to labeling individuals with a illness,” she mentioned.
The label, she added, “inexorably results in assessments and a seek for remedies.” And, she mentioned, “as a result of the individual, who now has turn out to be a ‘affected person,’ is asymptomatic, extra assessments and potential remedies generally won’t make the individual really feel any higher.”
Folks can go from considering of themselves as wholesome to considering of themselves as somebody with a illness. “Now, every time they expertise the widespread aches, pains and twinges of life, they marvel whether it is as a result of they’ve this ‘illness,’” Dr. Redberg mentioned. “They usually could then go to the physician and even emergency room for issues they’d not have beforehand. And that additionally will result in extra assessments and procedures, with their attendant danger of harms.”
Others, whereas enthusiastic concerning the prospects for polygenic danger scores, say that docs have to know extra about how efficient early intervention could be.
Dr. Iftikhar Kullo of the Mayo Clinic in Rochester, Minn., requested, “Do you truly enhance long-term outcomes” through the use of the assessments and appearing on them?
