Same Patient. Same Lab. Different Calculator. Different Prescription

The new 2026 cholesterol guideline just replaced the national heart risk calculator — and 17 million Americans no longer qualify for a statin because of it.4.1 million of them are currently taking one.Here's what makes this worth examining closely:↳ The new PREVENT calculator cuts mean 10-year ASCVD risk nearly in half nationally (8.0% → 4.3%)↳ Black adults saw the largest drop: 10.9% → 5.1%↳ Adults aged 70–75: 22.8% → 10.2%↳ No randomized trial has established that PREVENT produces better cardiovascular outcomes than the old PCE↳ The derivation dataset (Optum Data Warehouse) is proprietary — not publicly available for independent audit↳ And while we debate calculators, 15.8 million already-eligible Americans aren't taking the statin they qualify forThe calculator isn't the bottleneck. Access, cost, adherence, and follow-through are.In the latest episode of Dispense As Written, I break down what actually changed, what we don't know, and what the most important number in this paper really is — and it has nothing to do with which equation you use.Castelli Coefficient: 6/10. The therapy earns the score. The tool doesn't.🎥 Full episode linked in comments.—Dispense As Written is an independent, unsponsored evidence-based medicine education platform. No pharmaceutical funding. No substitutions.⚖️ LEGAL DISCLAIMER: This content is produced by Dispense As Written, LLC and is intended for educational purposes for healthcare professionals only. It does not constitute medical advice and should not be used to guide individual patient care decisions. Dispense As Written, LLC operates independently of Gregory Castelli's academic and institutional roles. No pharmaceutical sponsorship, funding, or promotional consideration was received in the production of this content.#EvidenceBasedMedicine #MedEd #PrimaryCare #FamilyMedicine #Dyslipidemia #DispenseAsWritten