Which vaccines the CDC recommends during pregnancy

 

 Most Americans are unaware or unsure of which vaccines the Centers for Disease Control and Prevention (CDC) recommends during pregnancy, according to a nationally representative survey of U.S. adults by the Annenberg Public Policy Center (APPC) of the University of Pennsylvania.

Almost half of those surveyed know that the CDC recommends getting the seasonal flu vaccine during pregnancy, while less than a third know that the CDC recommends the Tdap (tetanus, diphtheria, and pertussis), RSV (respiratory syncytial virus), and hepatitis B vaccines if one is not up to date on these vaccinations.

For the Covid-19 vaccine, over half of those surveyed do not know whether the CDC recommends it during pregnancy. While the CDC says that the vaccine helps reduce the risk for severe illness from Covid-19, it does not explicitly say the vaccine is recommended. Instead, the CDC says its Covid-19 vaccine recommendations are “now based on individual decision making, which emphasizes considering the benefits and risks of vaccination.”

Women of childbearing age (ages 18-49) are significantly more knowledgeable than other adult groups about most of the CDC’s pregnancy vaccine recommendations, although many in this group are also not sure what is recommended.

Uncertainty is a dominant finding in this survey. For each of four vaccines the CDC recommends during pregnancy, at least 45% of respondents are not sure whether the CDC recommends it.

The findings come from an APPC survey conducted on the research company SSRS’s Opinion Panel Omnibus platform among 1,031 U.S. adults from July 1-5, 2026. For further details, download the topline or see the end of this release.

“Our findings suggest that many Americans do not know which vaccines are recommended during pregnancy,” said Ken Winneg, APPC’s managing director of survey research. “The encouraging news is that relatively few people think that the CDC recommends vaccines that are not advised during pregnancy. The challenge is overcoming the widespread uncertainty over what the CDC does recommend.”

CDC recommendations during pregnancy

According to CDC guidance, four vaccines routinely recommended during pregnancy include:

• Seasonal influenza vaccine during flu season.
• Tdap vaccine during every pregnancy, preferably between 27 and 36 weeks’ gestation.
• RSV vaccine during weeks 32-36, administered during RSV season, which is September through January in most of the continental United States. Additional doses are not recommended during subsequent pregnancies.
• Hepatitis B vaccination for individuals who have not already been vaccinated.

The CDC says: “Covid-19 vaccination offers the greatest benefit if you are at higher risk for severe illness, including if you are pregnant. Pregnancy increases your risk of becoming very sick from Covid-19.” It adds that if you get sick with Covid-19 during pregnancy, you are at increased risk of complications that can affect your health and the health of your baby. The CDC recommends that Covid-19 vaccination decisions be made through individual decision making after considering the benefits and risks.

Other medical professionals more clearly back the Covid-19 vaccine during pregnancy. The American College of Obstetricians and Gynecologists (ACOG) strongly recommends that pregnant individuals be vaccinated against Covid-19 and “continues to recommend that all pregnant and lactating individuals receive an updated COVID-19 vaccine or ‘booster.’”

Awareness of recommended vaccines is low

Survey respondents were asked whether the CDC recommends each of eight vaccines during pregnancy. In addition to the five vaccines noted above, respondents were asked about three vaccines the CDC does not recommend during pregnancy: MMR or measles, mumps and rubella; chickenpox or varicella; and human papillomavirus or HPV.

Among U.S. adults overall, about a quarter to less than half of adults correctly identify any of the CDC-recommended vaccines, with the fewest (23%) knowing that the CDC recommends the hepatitis B vaccine during pregnancy and the most (48%) knowing the seasonal flu vaccine.

With the exception of RSV, women age 18 to 49 are significantly more likely than other groups (all adult men and women over 49 years old) to correctly identify all of the CDC-recommended vaccines. Among women 18 to 49, the vaccine least known to be recommended during pregnancy is the hepatitis B vaccine (30%) and the most known is the seasonal flu vaccine (60%).

Uncertainty dominates

For most of the vaccines, the most common response to whether the CDC recommends it during pregnancy is “not sure.” For each of the four recommended vaccines and the Covid-19 vaccine, from 45% to 66% of the overall adult population was not sure whether these were recommended. Among women of childbearing age, from 32% to 58% were not sure for each of the vaccines.

Few incorrectly think non-recommended vaccines should be taken

Current CDC guidance advises against administering the MMR and chickenpox vaccines during pregnancy because they are live-virus vaccines. The MMR and chickenpox vaccines should be given only before or after pregnancy. HPV vaccination is not recommended during pregnancy and should be delayed until after pregnancy if needed.

The survey found that relatively small groups of people incorrectly think that CDC recommends these vaccines:

• 21% say the CDC recommends the MMR vaccine during pregnancy.
• 17% say the CDC recommends human papillomavirus (HPV) vaccination.
• 17% say the CDC recommends chickenpox (varicella) vaccination.

Women of childbearing age are no more likely than others to incorrectly identify these vaccines as recommended. For the HPV vaccine, for example, 20% of women 18-49 years old incorrectly say it is recommended during pregnancy, compared with 16% of others, which is not a statistically significant difference.

For all three of these vaccines, the bigger issue is that a majority of respondents are not sure whether the CDC recommends that they should or should not be taken during pregnancy.

“Many Americans routinely get their immunizations from their primary healthcare providers or at local pharmacies, said Patrick E. Jamieson, director of APPC’s Annenberg Health and Risk Communication Institute, which oversees the health surveys. “It is critical that those professionals pay special attention to vaccine recommendations for recipients who are pregnant.”

Collagen peptides support bone health for female runners

 

Collagen is a protein found in skin, hair, nails, tendons, cartilage, and bones.

Our bodies naturally produce collagen using the foods we eat. But, in recent years, collagen peptides have gained popularity as a supplement to support joint, hair, skin, and gut health.

A new study led by Jennifer Fields, assistant professor of nutritional sciences in the College of Agriculture, Health and Natural Resources (CAHNR), provides evidence in favor of yet another application for collagen peptides – protecting female runners’ bones.

The study was published in Frontiers in Nutrition.

Bone health is a significant concern for endurance runners because, by the nature of their sport, they are consistently putting significant strain on their bones.

By putting stress on the bones, running activates osteoclasts to break down damaged bone. If a runner is, intentionally or not, not consuming enough calories, the osteoblasts that create new bone don’t have the fuel they need to rebuild the bone properly. This can lead to injury and long-term conditions like osteoporosis.

“Oftentimes, we associate running with being bad for us, bad for our bones, because runners are at a higher risk of stress-related injuries,” Fields says. “But oftentimes, it’s due to just simply under fueling and not giving your body enough calories to support training and recovery and adaptation.”

This is particularly relevant for female runners due to how the bone remodeling cycle interacts with hormones. Insufficient caloric intake lowers estrogen and progesterone levels, which in turn leads to increased bone breakdown and reduced bone formation.

Fields decided to study if collagen peptides could help intervene in this process, given that 90-95% of the organic bone matrix is comprised of collagen.

Collagen peptides are “incomplete amino acids.” Unlike complete amino acids, they do not trigger a response in our muscles. Instead, because of their unique structure (a repetitive pattern of three amino acids), they can trigger osteoclast and osteoblast activity.

“Unlike most dietary proteins, some of the dipeptides and tripeptides that make up collagen peptides can be absorbed intact by our intestine,” Fields says. “Those di- and tripeptides are what can potentially act on these osteoblast and osteoclast pathways to trigger a better bone turnover response where we’re favoring more bone formation.”

In this pilot study, Fields and her collaborators found that collagen peptides did indeed improve bone turnover. Looking at biomarkers in participants’ blood, the researchers saw that markers associated with bone formation increased and inflammation decreased in the group that took the collagen peptide supplements.

“We’re seeing some good preliminary data to show that four weeks is sufficient to move some of those acute biomarkers,” Fields says.

Other studies had looked at collagen peptides for bone health in postmenopausal women. Research on premenopausal women, on the other hand, has been extremely limited, and no one had looked at female runners specifically, despite their elevated risk of impaired bone remodeling and heightened risk of bone stress injuries.

Women’s bone density is generally not checked until after they enter menopause. But about 90% of bone mass develops by 18 and the remaining 10% by age 30. This means supporting bone health in young women is critical to ensuring their lifelong health and wellness.

“If we can target the premenopausal population and identify individuals who might be at risk of maladaptive bone responses, then hopefully we can reverse it and prevent early-onset osteopenia and osteoporosis,” Fields says.

Collagen peptides also have known benefits for hair, skin, joints, and gastrointestinal health, meaning incorporating them into the diet can have a host of benefits beyond bone health.

“What’s great about collagen peptides is that they’re universal,” Fields says. “It’s not a supplement where we’re only expecting one outcome. It can be incorporated into the diet as a supplement to help with some of these other health benefits.”

---

Journal

Frontiers in Nutrition

DOI

10.3389/fnut.2026.1825906 

My latest supplement

Ceylon cinnamon—often called "true cinnamon"—is a potent spice known for supporting blood sugar management, reducing inflammation, and offering heart protection. Its standout advantage over common Cassia cinnamon is extremely low coumarin levels, making it the safest choice for daily consumption. [1, 2]

Ceylon cinnamon provides several evidence-based benefits:

Blood Sugar Regulation: It helps improve insulin sensitivity and slows the breakdown of carbohydrates after meals, assisting in blood sugar management. [1]
Reduced Inflammation & Oxidative Stress: It is rich in antioxidants like polyphenols and cinnamaldehyde, which combat chronic inflammation and protect against cell damage. [1, 2]
Heart Protection: Regular intake is associated with reduced levels of total cholesterol, LDL ("bad") cholesterol, triglycerides, and blood pressure. [1]
Antimicrobial Properties: The spice contains natural properties that help fight off bacteria, fungi, and viruses. [1, 2]

Also see:

https://healthnewsreport.blogspot.com/2026/04/some-of-my-supplements.html

https://healthnewsreport.blogspot.com/2026/04/5-more-of-my-supplements.html

 

Yo-yo dieting might mean losing muscle, too

 

Repeatedly losing and gaining weight may do more than frustrate dieters — it also accelerates muscle loss in middle-aged people, according to new UC San Francisco research that comes as weight-loss medications transform obesity treatment.

In a study published July 21 in Radiology, the researchers found that people whose weight repeatedly fluctuated lost significantly more thigh muscle over four years than people whose weight remained relatively steady, even though both groups finished the study at about the same overall weight as when they began.

“When people’s weight cycled, they lost tremendous amounts of muscle along with the fat, and they didn’t gain the muscle back,” said Thomas Link, MD, PhD, professor of Radiology, who led the study, along with co-first authors, Adrian A. Marth, MD, and Gabby Joseph, PhD. “This tells us that understanding how to protect muscle while people are losing weight is important for overall health.”

Although the study was not conducted in people taking GLP-1 drugs, Link said that the insight addresses a question likely to become increasingly important as more people go on and off weight-loss therapies.

Looking beyond the scale

The researchers analyzed MRI scans and health data from 1,433 middle-aged participants in the Osteoarthritis Initiative, a long-running study of adults at risk for knee osteoarthritis that is funded by the National Institutes of Health. While some participants maintained a stable weight during the four-year study, others experienced repeated weight fluctuations.

Using artificial intelligence to analyze MRI scans, the team measured thigh muscle volume, fat within the muscles, and fat surrounding the knee. The difference between the two groups was striking.

People whose weight repeatedly fluctuated lost nearly four times as much thigh muscle over four years as those whose weight remained relatively steady. The loss was about 3.7% of thigh muscle volume in weight cyclers, compared with about 1% in non-cyclers, after accounting for age, sex, baseline BMI, physical activity, diet, and other health factors.

The findings also suggest that preserving muscle during weight loss deserves as much attention as losing fat.

“We need to better understand how weight loss affects the body in ways that aren’t about the number on the scale,” said Link. 

"Fat loss is just one piece of a much larger puzzle that includes how weight loss affects arthritis, muscle, bone, and other factors," Link said. "As more people use effective weight-loss therapies, we need to be thinking about how those pieces fit together.”

How many cups of caffeinated coffee are safe and good for you to drink each day?

Highlights:

• The latest research indicates that consuming up to 400 mg of caffeine/day (equivalent to up to 5, 8-ounce cups of caffeinated coffee per day) is generally safe for most adults and appears to be linked to a lower risk of several cardiovascular conditions, including heart failure, heart disease and stroke in some individuals.
• However, higher amounts of caffeine, such as levels found in energy drinks including energy shots, may increase the risk of high blood pressure and/or irregular heart rhythm or arrhythmia.
• More research is needed to better understand caffeine’s impact on the body, how different sources of caffeine impact heart health and how its impact may vary among different people, according to the scientific statement.

Previous studies have found that caffeine is the world’s most popular stimulant and psychoactive sub­stance, and coffee is the most common way people consume caffeine. The latest research supports the conclusion that for most adults, consuming up to 400 mg of caffeine/day (or up to 5, 8-ounce cups of caffeinated coffee per day) is safe and appears to be linked to a lower risk of cardiovascular disease for some individuals. However, higher doses of caffeine, such as levels found in energy drinks including energy shots, may cause cardiovascular harm, according to a new American Heart Association scientific statement, “Caffeine and Cardiovascular Disease,” published today in the American Heart Association’s flagship peer-reviewed scientific journal Circulation.

“Caffeine consumed in coffee is a key part of daily life for millions of people, and in our review of the most recent research, for most adults, intake of up to 400 mg of caffeine/day, the equivalent of up to 5 cups of caffeinated coffee per day without added sugars or fillers, is safe and does not increase cardiovascular risk,” said Chair of the scientific statement volunteer writing group Gregory M. Marcus, M.D., M.A.S., FAHA, a professor of medicine at the University of California, San Francisco School of Medicine and the associate chief of Cardiology for Research at the University of California, San Francisco Health. “However, high doses of caffeine, such as those found in energy drinks including energy shots, may have harmful effects on the heart and should be avoided.”

The statement authors note that studying the effects of caffeine on the cardiovascular system is challenging. Coffee is the main source of caffeine in most research studies, and the observed cardiovascular effects may be due to other compounds in coffee. For example, experimental studies suggest that the bioactive compounds in coffee may have antioxidant and anti-inflammatory properties, which may help explain some health benefits. It’s also difficult to separate the effects of caffeine from other ingredients usually added to coffee, such as milk, cream, flavored syrups and/or sugar. In addition, most studies on caffeine are observational, meaning they cannot prove cause and effect. 

Although coffee is the main source of caffeine for most adults, tea, chocolate, soda and energy drinks, as well as over-the-counter and prescription medications, also contribute to overall caffeine intake. More research is needed about other products with caffeine in order to understand caffeine content and caffeine’s impact on cardiovascular health.

The new scientific statement details the most recent research primarily on caffeinated coffee and the potential impact of caffeine in coffee on high blood pressure, cholesterol, Type 2 diabetes, coronary heart disease, stroke, heart failure, atrial fibrillation, other arrhythmias and other cardiovascular conditions.

Caffeine and cardiovascular health: key things to know

• Based on the results of the latest research studies reviewed, consuming up to 400 mg of caffeine per day, or no more than 3 to 5, 8-ounce cups of regular black caffeinated coffee per day (without sugars, sweeteners, flavors or added fillers), is considered safe for most adults. A regular brewed, non-specialty, caffeinated coffee typically contains 9.4-20.6 mg of caffeine per fluid ounce.
• Consuming caffeinated coffee without added sugars, flavors or cream was linked to a lower risk of Type 2 diabetes, heart disease, stroke, heart failure and some irregular heart rhythms.
• Randomized trials, the most rigorous and reliable type of study design, have shown that caffeine consumption in coffee is associated with a lower risk of atrial fibrillation but also a higher risk of premature ventricular contractions.
• Adding sugar, flavored syrups, milk and/or cream to coffee likely reduces its potential health benefits, and more research is needed to understand the impact of these additives.
• Higher caffeine intake, such as levels found in energy drinks including energy shots, was associated with cardiovascular harm, such as increased risk of high blood pressure and irregular heart rhythm. Energy drink shots may contain 40-69 mg of caffeine per fluid ounce, 3-4 times more caffeine than regular caffeinated coffee.

How does caffeine affect the body?

Caffeine consumed in coffee is metabolized by the liver and generally reaches peak concentration for most people within an hour. However, how quickly individuals process caffeine depends on their genetics, metabolism, age and past caffeine use. When more caffeinated coffee is consumed regularly, some people may develop a tolerance to higher levels of caffeine. Other people may feel stronger effects from the same amount of caffeine. Short-term effects of caffeine may include temporary increases in blood pressure, heart rate, blood sugar and alertness. Some people may experience heart palpitations and/or sleep disruption.

Specific health impacts of caffeine:

• Effects on blood pressure: Studies have found that caffeinated coffee consumption may affect blood pressure differently depending on how much is consumed. In people with optimal blood pressure, drinking 1–3 cups a day was associated with an increased risk of developing high blood pressure, while drinking more than 3 cups per day was associated with a lower risk. High doses of caffeine (such as those from energy drinks or energy shots) can significantly increase blood pressure, especially in people who already have high blood pressure.

• Effects on Type 2 diabetes: Research suggests that caffeinated coffee may reduce insulin sensitivity in the short term. In addition, drinking black, caffeinated coffee (no additives, flavors or sweeteners) regularly was linked to a lower risk of developing Type 2 diabetes. However, this benefit may be due to compounds in coffee other than caffeine. More research is needed to clarify the impact on Type 2 diabetes of caffeinated coffee vs. various compounds in coffee.

• Effects on cholesterol: Data from randomized clinical trials indicate cafestol, a component in both caffeinated and decaffeinated coffee, was associated with higher levels of low-density lipoprotein (also known as “bad” cholesterol). Cafestol is present in unfiltered coffee (such as espresso, French press, Turkish coffee or boiled coffee) but not present in coffee brewed with paper filters or instant coffee. More research is needed to understand which products have higher levels of cafestol and their mechanisms.  

• Effects on heart rhythm: The most recent analyses of health measures with self-reported information from participants have found that drinking 1-3 cups of caffeinated coffee per day was not associated with an increased risk of atrial fibrillation or abnormal heart rhythm. However, caffeinated coffee at that same level may be associated with more early beats from the lower chamber of the heart, called premature ventricular contractions (or PVCs). Very high doses of caffeine (such as those in caffeinated energy drinks or energy shots) have been linked to abnormal heart rhythm in people usually considered to have low cardiovascular disease risk, such as healthy adults younger than age 30.

• Effects on heart disease and stroke: Drinking 2-4 cups of caffeinated coffee per day was linked to a lower risk of heart disease, heart failure and stroke. However, drinking more than 4 cups of caffeinated coffee a day may increase the risk of heart failure.

Not all sources of caffeine are the same

More research is necessary to investigate the different health impacts of various types of caffeinated coffee and other products with caffeine, such as tea, soda, energy drinks and energy shots, and foods. There have been fewer studies focused on tea vs. coffee; however, tea has been associated with reduced risk of atrial fibrillation, heart failure and stroke, similar to caffeinated coffee. Energy drinks, bars, gels and caffeine-based supplements often contain other added ingredients that may increase the absorption of caffeine, may accelerate its effects on the body, may raise blood pressure and increase the risk of cardiovascular harm.

More randomized controlled trials investigating the effects of caffeine in coffee and other products that have caffeine on cardiovascular health are needed to better understand how caffeine affects different people and how different sources of caffeine impact heart health. The writing group emphasized that there is also a need for research focused on caffeinated energy drinks and other popular products containing caffeine. Due to the lack of sufficient, rigorous data to develop guidance on recommendations for caffeine intake, caffeine was not referenced in the Association’s 2026 Dietary Guidance to Improve Cardiovascular Health. 

“Although research suggests that caffeine consumption may be associated with certain cardiovascular benefits for some people, it’s important to remember that there is no ‘one-size-fits-all’ strategy for safe caffeine consumption. People can respond very differently to caffeine based on various factors, such as age, medications, underlying health conditions, genetics and how quickly their bodies metabolize it. What may be a reasonable amount for one person could cause unwanted effects, such as heart palpitations, anxiety or sleep disruption, in another. That’s why it’s important to pay attention to how your body responds to caffeine and talk with your healthcare team about what is right for you,” Marcus said.

This scientific statement was prepared by the volunteer writing group on behalf of the American Heart Association’s Council on Lifestyle and Cardiometabolic Health; the Council on Clinical Cardiology; and the Stroke Council. American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.

Brain development risks associated with certain medications during pregnancy

 

The medications studied include some statins, antidepressants, anxiety medications and cardiovascular drugs.

Cholesterol is a vital molecule, especially during embryonic development. Disruption of the cholesterol biosynthetic pathway can arise from pathogenic genetic variants or exposure to prescription medications. A study published in Molecular Psychiatry investigated the relationship between fifteen sterol biosynthesis inhibiting medications (SBIM) prescribed during pregnancy and the incidence of autism spectrum disorders (ASD) in the resulting offspring. The study included 6,135,213 children with linked maternal health records.  

The study evaluated the incidence of ASD associated with maternal prescription of aripiprazole, atorvastatin, bupropion, buspirone, fluoxetine, haloperidol, metoprolol, nebivolol, pravastatin, propranolol, rosuvastatin, sertraline, simvastatin, and/or trazodone during pregnancy.  

The study found that exposure to at least one SBIM during pregnancy was associated with a 1.47-fold (95% CI 1.45–1.49) increased risk of an ASD after adjusting for potential confounders. For each additional SBIM co-prescribed, there was a 1.33 (95% CI 1.32–1.34) times increased risk of ASD, reaching 2.33-fold risk when 4 or more SBIMs were prescribed simultaneously. 

Notably, in our dataset, utilization of SBIM medications by pregnant women increased from 4.6% in 2014 to16.8% in 2023. 

In conclusion, SBIMs may be potentially harmful to the developing fetus. Given that these drugs account for over 400 million prescriptions annually in the U.S. these should findings be considered before prescribing SBIM medications during pregnancy.

More than half of U.S. adults now eligible for statins under new guidelines

 

More than half of U.S. adults ages 30 to 79—about 87.5 million people—are now recommended for statins to prevent cardiovascular disease under newly updated clinical guidelines, according to a study by University of Pittsburgh School of Medicine researchers published today in JAMA.

 

The new recommendations significantly change how doctors assess cardiovascular risk by looking beyond the next 10 years to a person’s risk over several decades. Even though newer calculators often estimate lower short-term risk than older tools, the guidelines broaden statin eligibility. As a result, an additional 21.5 million Americans are now recommended for statins, bringing the total to 56.6% of adults ages 30 to 79.

 

In March 2026, the American Heart Association, the American College of Cardiology and others released updated guidelines for managing high cholesterol to help prevent cardiovascular events, including heart attacks and strokes. The recommendations incorporated an updated risk calculator released in 2023 and broadened eligibility by expanding the age range from 40–75 to 30–79 and extending the risk horizon from 10 years to 30 years.

 

“The shift to a longer view of cardiovascular disease risk is a sea change for doctors in counseling patients,” said Timothy S. Anderson, M.D., M.A.S., a primary care physician, health quality researcher and assistant professor of medicine at Pitt. “We wanted to better understand the potential population-health effect of this shift.”

 

“Before the new guidelines, people who were flagged with high cholesterol in their 30s and 40s tended to be recommended to focus on diet and exercise and were not recommended medication—unless the patient already had heart disease or other factors that made them particularly high-risk, like diabetes.”

 

The team analyzed data from 4,366 participants in the National Health and Nutrition Examination Survey, representing about 154.5 million U.S. adults who do not have existing cardiovascular disease, from 2017 to 2023. The analysis focused specifically on primary prevention—reducing risk before a heart attack or stroke occurs—and did not include pregnant individuals in the study sample.

 

The results showed that age remains a strong predictor of risk. Relatively few—just 11.1%—of adults in their 30s are recommended statins. Eligibility increases steadily over time, with 85% of people in their 60s and most individuals in their 70s—93.5%—qualifying under the new guidelines.

 

The vast expansion of people recommended for treatment is heavily driven by patients who are generally considered to be at low risk in the shorter term, meaning they are under 3% risk of having a heart attack or stroke within 10 years, but modest risk—over 10%—within 30 years.

 

Anderson, who was a member of the committee that wrote the new guidelines, acknowledges that they represent a major conceptual shift for patients, too, as they face the question of whether to start a daily medication now to prevent something from happening more than 10 years down the road.

 

“Many of my younger patients wonder why they can’t put off starting treatment—which is understandable, given they might have low risk of a cardiovascular event 10 years out—and some likely can with a strong focus on healthy diet, exercise and weight. But for patients seeking to fully minimize risks of heart attacks and strokes, early statin therapy may be a good choice.”

 

Anderson adds that the biology of cardiovascular disease is an evolving story.

 

“Observational evidence suggests the longer people are exposed to high levels of inflammatory cholesterol molecules, the greater their downstream risks of heart attacks and strokes are. Unfortunately, we do not have randomized clinical trials for low-risk people 30 years out that would directly support this new understanding of how risk builds more gradually over the years—because such trials are expensive, and we need to wait decades for the answer,” he said.

 

“Ultimately, in this grey zone, patients should talk to doctors. This is a preference-based decision that should take into account the potential for modest cardiovascular risk reduction alongside the potential for adverse drug events, costs and patient preferences.”

 

Importantly, Anderson stresses, medication is not the only tool in the toolkit for cardiovascular disease prevention. “It's certainly very reasonable that many people will talk about this with their doctor and say, ‘Okay, what can I do that does not involve medication?’” Physicians have long recommended lifestyle changes like healthy diet, exercise and smoking cessation to all their patients, regardless of whether they have high cholesterol—and will continue to do so.