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Reality stands in the way of a quickly transformed U.S.-Russia relationship, Stanford historian Norman Naimark said. Naimark, an expert in Russian history and faculty affiliate at Stanford’s Center for International Security and Cooperation (CISAC), anticipates that "strategic constraints" will set in for the incoming Trump administration as it begins to understand some of the fundamental differences between Moscow and Washington.

The relationship between the two longtime global rivals may not change as fast or dramatically as some suggest, Naimark said. In fact, “deals” may be harder to make with the Putin regime in Russian than Trump anticipates.

CISAC recently interviewed Naimark on the subject of future U.S.-Russia ties:

How might the election of Donald Trump change the U.S.-Russia relationship?

There are many important things we do not yet know about the future Trump administration. How will his foreign policy team reflect (or not) the views of the Republican establishment, including the vice president, on issues towards Russia? How wedded is Trump to his campaign rhetoric and promises about Russia? How influential will the new president be in the making of foreign policy, when his interests and self-proclaimed competence clearly relate to domestic issues? How ready will the Trump administration be to reverse long-standing U.S. treaty and alliance obligations, both formal and informal?

Answers to those questions would help us assess the range of possibilities for any changes in Russian-American relations, which are presently worse than at any time since the beginning of the 1980s, the period of what some call the “second Cold War.” If Hillary Clinton had won the election, one could have been fairly certain that relations would have continued at their present parlous, if steady state, with both sides taking actions to undermine the other, while criticizing the other’s motives. Some commentators have suggested that the Trump victory opens a door for concessions on the part of the Americans – on Crimea, on Ukraine, on Syria, on sanctions, on NATO troops in the eastern member nations – that might encourage Putin to respond accordingly, improving the tone and content of Russian-American relations.

But I would caution against thinking that this will come fast, if it comes at all, or that the impact will be groundbreaking or of significant duration. There are some fundamental differences between Moscow and Washington that reflect deep and abiding issues. For example, both look at Russia’s “sphere of influence” from opposite perspectives: while Putin seeks to expand and consolidate it, the U.S. follows a revived containment policy. “Deals” may be harder to make with Russia under these circumstances than Trump anticipates.

If U.S. foreign policy establishment generally holds skeptical views of the Putin regime, how difficult will it be for Trump to strike off on his own in reshaping the relationship?

The history of American foreign policy since the Second World War has demonstrated that the president and his immediate advisors can have enormous influence on the flow of events. Again, nothing happens at once, independent of a cumbersome process of formulating and executing policy changes. But profound shifts do happen and they can alter the trajectory of American foreign policy. Still it is important to remember that Putin’s determined anti-American stance has Russian domestic political determinants that will impede change, even if President-elect Trump initiates steps to improve the character of the relationship.

What are the biggest flashpoints or challenges between Russia and the U.S.?

Ukraine, Syria, and the lifting of sanctions are probably at the top of the list, though the recent slippage of the arms control regime is a matter of great concern. The problems associated with Ukraine – both the issue of the illegal annexation of Crimea and the Russian destabilization of and military interference in Donbass – have been “handed off” by Washington to the Europeans in general and Germany, with Angela Merkel in the lead, in specific.

The Minsk II sanctions are a European initiative to get the Russians to conform to international norms on a Ukrainian settlement. Trump could hardly make a deal with Putin about Ukraine without serious European input.

Syria is different, though the constraints here also seem extremely difficult to overcome, given the U.S.’ principled opposition to strengthening Assad in power. Secretary of State John Kerry’s dogged attempts to come to an agreement with the Russians about Syria involved, as best we know, a number of important American concessions. Though both the United States and the Russian Federation are deeply hostile to ISIS, and it makes sense for both to join forces to attack the terrorist entity, the maintenance of the Assad regime would be very hard for the U.S. foreign policy and military establishment to accept.

Why does Putin seemingly think Trump is better for Russia than Hillary Clinton would have been?

Some of it is personal: Trump and Putin have said positive things about one another, though these exchanges were based in part on a mistranslation of a supposed compliment to Trump by Putin. Trump has been more conciliatory about dictators and has explicitly promised better relations with Russia. But the issues go deeper. Trump has indicated that he would reduce the United States’ support of NATO and reevaluate U.S. support of Ukrainian interests, both of which would weaken the American position in Europe, one of Moscow’s major foreign policy goals.

The Russian president also welcomes Trump’s readiness to recalibrate American involvement in Syria. Meanwhile, Clinton was seen as having tried to undermine Putin’s election to the Russian presidency in 2012 and as supporting an aggressive democratization program in Russia. She is the personification for him of the liberal, internationalist, and interventionist wing of the Washington foreign policy establishment that advocates, in his view, the Americanization of the international order.

With this said, Putin is surely nervous about Trump’s inconsistencies and volatility, which could exacerbate rather than calm Russian-American tensions.

What does history tell us about the U.S.-Russia relationship and what may happen in the future?

Since the beginning of the Cold War (some might argue since the Russian Revolution, almost a century ago), the relationship between the U.S. and Russia has been fraught with deep tensions and mutual hostility. The Cold War was a very dangerous period of relations, when proxy wars, dramatic international crises, and the potential use of nuclear weapons dominated the relationship. One of the major disappointments of the post-Cold War period is the unsuccessful integration of the Russian Federation in the international system as a force for peace and stability. Putin is an important part of the story. But there are also deep historical and structural reasons for this problem and they will not be solved by the waving of an American president’s magic wand. Though both countries are changing, we may have to wait a good long while for the Putin-era enmity to disappear.

Naimark is also the Donald Andrews Whittier Fellow at the Stanford Humanities Center, the Robert and Florence McDonnell Professor of East European Studies in the history department, a senior fellow of the Hoover Institution and an affiliated faculty fellow at the Europe Center at the Freeman Spogli Institute for International Studies. He recently published a new book, Genocide: A World History.

Follow CISAC on Twitter at @StanfordCISAC and on Facebook at www.facebook.com/StanfordCISAC.

MEDIA CONTACTS

Norman Naimark, Center for International Security and Cooperation: (650) 723-2674, naimark@stanford.edu

Clifton B. Parker, Center for International Security and Cooperation: (650) 725-6488, cbparker@stanford.edu

 
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Photo of a gala concert held in Red Square to mark the 70th anniversary of the former Soviet Union's role in WWII. Stanford scholar Norman Naimark said that "strategic constraints" will set in for the incoming Trump administration as it begins to understand some of the fundamental differences between Moscow and Russia.
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Stanford economist Takeo Hoshi joined Nikkei CNBC’s television program “Night Express” in Tokyo to discuss what a U.S. presidency under Donald Trump holds for trade policy, U.S.-Japan relations and the global economy.
 
Hoshi, who is also the Japan Program director at the Shorenstein Asia-Pacific Research Center, said that, while many of the next administration’s plans remain uncertain, the president-elect's first task would be to bridge divisions among Republicans so it can move ahead on policy decision-making.
 
The television segment can be viewed in Japanese here.

 

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Amy Zegart, co-director of CISAC, wrote the following op-ed for the San Francisco Chronicle:

Donald Trump’s stunning win has made many wonder: Just how dangerous could a Trump foreign policy be? There are plenty of reasons to be afraid, very afraid.

Trump knows almost nothing about national security but says his own top adviser would be himself. He has said he might use nuclear weapons against the Islamic State and would abandon the North Atlantic Treaty Organization and our Asia-Pacific allies unless they paid more — as though alliances are a two-bit mafia protection racket rather than an enduring source of American power projection across the globe. He doesn’t know what the U.S. nuclear triad is (it’s the cornerstone of our deterrence against total nuclear war), and he doesn’t care that he doesn’t know.

He dismisses U.S. intelligence reports attributing election hacking to the Russian government as “public relations.” And his Twitter trigger fingers have alarmed many about putting a man with so little obvious self-control anywhere near the U.S. nuclear codes. Three reasons, however, suggest that a Trump foreign policy might not be the doomsday scenario that many fear.

The first is the heavy burden of office. All presidents feel it. Campaigning is one thing, governing is another. Candidate Jimmy Carter railed against the Central Intelligence Agency during the 1976 presidential campaign and vowed to declaw it. President Carter did the opposite, embracing covert operations and declaring in his 1981 State of the Union message that, “Our national interests are critically dependent on a strong and effective intelligence capability.” Nothing is more sobering than seeing, up close, every day, what dangers confront the United States and threaten our vital interests. The campaign trail is exhilarating. The Oval Office is exhausting. Leading the most powerful country on Earth is an awesome responsibility that every president feels. That’s why they seem to age in dog years. 

The second check on recklessness is Congress. To be sure, presidents have far more unilateral powers when it comes to foreign policy than domestic policy. But Congress still matters. Congress controls the purse and oversees the executive branch — often times, not so well. But in moments of crisis, Congress does weigh in because voters back home demand it. Congressional pressure — and the prospect that Congress would cut off funding — finally pushed President Richard Nixon to end the Vietnam War. National Security Agency surveillance was dramatically reformed when Congress passed the USA Freedom Act in 2015. CIA assassination plots against foreign leaders ended when Congress’ Church committee investigation uncovered them and said, “enough.” To be sure, Republicans will again control the House and Senate come January. But the one thing that instantly unites all Republicans and Democrats is protecting their own power against an overreaching executive.

The third check is bureaucracy. American intelligence and military officials are professionals. They are trained to do their jobs regardless of who’s in power. While there are always exceptions (I’m thinking of you, FBI Director James Comey), the men and women who work at the tip of the spear of our national security establishment put country first. At the CIA, speaking truth to power is a cherished value. In the Pentagon, refusing to follow an unlawful order is deeply inculcated. These are not slogans on hats. These are the creeds by which our national security professionals live, and die. Spend any time at Strategic Command headquarters in Omaha, Neb., where there’s a red clock on the wall counting the time in seconds to nuclear impact on the operations center, and you’ll know just how real these values are. 

Implementing policy is harder than most people think. It takes time, it takes approvals, it takes organizational gears to grind, it takes coordination across agencies, it takes bureaucratic infighting and political maneuvering, and it often takes a bevy of lawyers. Every president complains that the process is far too cumbersome. Presidents issue plenty of orders that are not carried out quickly, or ever. Agendas are always long. Time is always short. Events often intervene. And concerned bureaucracies can wait it out while the president’s four-year term ticks away.

In the summer of 1952, when Dwight Eisenhower was running for president, Harry Truman famously captured just how hard it is to make change. Imagining how Eisenhower would handle the presidency, Truman remarked, “He’ll sit here and he’ll say, ‘Do this! Do that! And nothing will happen. Poor Ike — it won’t be a bit like the Army. He’ll find it very frustrating.” 

Let’s hope so.

 

 

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The CIA symbol is shown on the floor of the CIA Headquarters. The CIA is one of the government agencies that president-elect Donald Trump would find to be a check on any reckless national security decisions or actions, according to Stanford political scientist Amy Zegart.
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Marjorie Kiewit, a former CISAC researcher and longtime supporter, passed away at her home in Boston on Nov. 12, 2016.  She was 95.

Kiewit was a researcher for the Center for International Security and Cooperation under John W. Lewis, CISAC co-founder and the William Haas Professor of Chinese Politics. She was also a generous and enthusiastic supporter of CISAC’s mission to make the world safer through knowledge and education.

Lewis said, “Marjorie worked throughout CISAC in its formative years and supported with wonderful gifts the entire center. In the last 10 years or so, she primarily supported my project (the Project on Peace and Cooperation in the Asian-Pacific Region), but she embraced the overall center's commitment to peace.”

For example, Lewis and his co-author acknowledge the support of Kiewit that made this 2016 research paper on China’s interests in the South China Sea possible. Always maintaining such connections after her two-plus decades at Stanford, Kiewit worked on campus at the Northeast Asia-United States Forum and then CISAC. She also served as a member of Stanford’s Board of Visitors for the Institute of International Studies. 

One Stanford colleague said Kiewit possessed an “intuitively correct understanding of the world events and world leaders.”  Another described her as “engaged, intelligent and relevant to how we faced extraordinary challenges and opportunities with the Chinese, North Koreans and Russians. She brought light and joy into all of our work."

Roots and results

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Kiewit was born on May 28, 1921, in Milwaukee, Wis., to Kellogg and Laura Harkins. She graduated summa cum laude from Lawrence University in Appleton, Wis., in 1943.  Later, she married James Buchanan, and they resided in Neenah, Wis., with their four children. She served as president of the Neenah School Board, on the Wisconsin Governor's Commission in Education, and as first woman president of the Board of Trustees of Lawrence University. Kiewit attended the University of Chicago, where she received her doctorate in higher education in 1977. Upon graduation, she worked for the Dallas Independent School District as a senior analyst.  

Kiewit maintained her association with Stanford for over three decades until her death, during which time she traveled with high-level delegations to China, Russia, and North and South Korea and cultivated close relationships with Chinese educators and senior policy makers to share ideas and proposals in the field of educational and foreign policy. She was also the founder and served as longtime chairperson of the Helios Foundation, which supports charitable institutions throughout the world and promotes philanthropy for future generations. She spent the last 20 years living in Boston to be near family, which was always a priority in her life, her family stated.

Kiewit was preceded in death by her two husbands; parents; two brothers, John and William Harkins; and her daughter, Linda Jacob.  She is survived by her sister, Barbara Belle of Belleville, Wis.; her daughters Barbara (Jack) Aalfs of Sioux City, Iowa and Nancy (Tom) McLoughlin of Mystic, Conn.; her son John (Lynne) Buchanan of Appleton, Wis.; her son-in-law Jonah Jacob of Boston; and seven grandchildren, 12 great-grandchildren, and three step-grandchildren. 

A celebration of Kiewit's life will be held next summer in Appleton, Wis.  Donations in her memory may be made to the Marjorie Buchanan Kiewit Scholarship Fund at Lawrence University. The address is:

Development Office, Lawrence University

711 E. Boldt Way

Appleton, WI 54911

 

 

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Few people understand the high costs of medical services in the United States better than David Chan, a practicing physician and Stanford economist specializing in health care. But even Chan isn’t immune from sticker shock at the doctor’s office.

On a recent visit to his doctor, Chan underwent a routine test for seasonal allergies. He figured it would cost about $500. The actual charge was closer to $5,000.

“I should be one of health care’s most informed customers,” says Chan, who is a faculty member at Stanford Health Policy. “But like most people, I didn’t think to ask the price for the test and my doctor probably didn’t know it, anyway.”

To Chan, a faculty fellow at the Stanford Institute for Economic Policy Research and assistant professor at the Stanford School of Medicine, the experience illustrates what’s hobbling U.S. health care.

Although much research into health economics has focused on issues related to insurance, the delivery of patient care — specifically, how to lower costs and manage quality at the ground level — “is really where health care becomes a black box,” says Chan. Economics haven’t figured out why costs and patient outcomes vary widely, even from one hospital to the next in the same city.

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David Chan addresses the Health Policy 2020 symposium on Oct. 14, 2016.
David Chan addresses the Health Policy 2020 symposium on Oct. 14, 2016.
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Faculty from Anthropology, English and Political Science join Stanford students and staff for perspectives on the U.S. election and its implications for Mexico and Latin America, and for the prospects of immigrants living in the U.S.

(TBD) undergraduate (Centro Chicano and Latino Outreach and CORE Coordinator)

Lenica Morales-Valenzuela is a Masters in Latin American Studies student here at the Center of Latin American Studies. Her past research has focused on human rights advocacy for genocide survivors of the Guatemalan Civil War and studying root causes for Central American migration to the United States. Currently, her research is shifting towards issues of constitutionality of indigenous rights in Guatemala and how indigenous populations have been interacting (or not) with the Guatemalan state. 

 

#LatinxsReact

 

Speakers:

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angela garcia
Professor Garcia’s work engages historical and institutional processes through which violence and suffering is produced and lived. A central theme is the disproportionate burden of addiction, depression and incarceration among poor families and communities. Her research is oriented toward understanding how attachments, affect, and practices of intimacy are important registers of politics and economy.

Professor Garcia is currently engaged in research in Mexico City that examines emerging social and discursive worlds related to the dynamics of extreme urban poverty, mental illness and drug addiction in Mexico City, particularly within its peripheral zones.

 

 

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Dr. Paula M. L. Moya is Professor of English and, by courtesy, of Iberian and Latin American Cultures and the Director of the Research Institute of Comparative Studies in Race and Ethnicity at Stanford University.

She was also a founding organizer and coordinating team member of The Future of Minority Studies research project (FMS), an inter-institutional, interdisciplinary, and multigenerational research project facilitating focused and productive discussions about the democratizing role of minority identity and participation in a multicultural society.

 

 

Beatriz Magaloni Beatriz Magaloni
Beatriz Magaloni is an Associate Professor in the Department of Political Science and a Senior Fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford University. She is also an affiliated faculty member of the Woods Institute of the Environment (2011-2013), a Faculty Fellow at the Stanford Center for International Development, and became an affiliated faculty member at CISAC in 2014.

 

 

 

 

Moderator(s):

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Francisco Preciado, J.D., Executive Director SEIU Local 2007 at Stanford.  Francisco has experience working in local and state politics.  He has advised California State Assembly Members and State Senators, managed a non-profit, worked as a union organizer, and completed several legal externships.  He is a graduate of UC Berkeley School of Law, where he was recognized for his work assisting low-income workers.  Francisco has a Masters Degree in Mexican American Studies from San Jose State University, and a dual Bachelors Degree in Political Science and Chicano(a) Studies from Stanford University.

 

 

 

 

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alberto diaz
Alberto Diaz-Cayeros Director of the Center for Latin American Studies.  Alberto joined the FSI faculty in 2013 after serving for five years as the director of the Center for US-Mexico studies at the University of California, San Diego. He earned his Ph.D at Duke University in 1997. He was an assistant professor of political science at Stanford from 2001-2008, before which he served as an assistant professor of political science at the University of California, Los Angeles. Diaz-Cayeros has also served as a researcher at Centro de Investigacion Para el Desarrollo, A.C. from 1997-1999. His work has primarily focused on federalism, poverty and economic reform in Latin America, and Mexico in particular. He has published widely in Spanish and English.

Dept. of Political Science
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beatriz_magaloni_2024.jpg MA, PhD

Beatriz Magaloni Magaloni is the Graham Stuart Professor of International Relations at the Department of Political Science. Magaloni is also a Senior Fellow at the Freeman Spogli Institute, where she holds affiliations with the Center on Democracy, Development and the Rule of Law (CDDRL) and the Center for International Security and Cooperation (CISAC). She is also a Stanford’s King Center for Global Development faculty affiliate. Magaloni has taught at Stanford University for over two decades.

She leads the Poverty, Violence, and Governance Lab (Povgov). Founded by Magaloni in 2010, Povgov is one of Stanford University’s leading impact-driven knowledge production laboratories in the social sciences. Under her leadership, Povgov has innovated and advanced a host of cutting-edge research agendas to reduce violence and poverty and promote peace, security, and human rights.

Magaloni’s work has contributed to the study of authoritarian politics, poverty alleviation, indigenous governance, and, more recently, violence, crime, security institutions, and human rights. Her first book, Voting for Autocracy: Hegemonic Party Survival and its Demise in Mexico (Cambridge University Press, 2006) is widely recognized as a seminal study in the field of comparative politics. It received the 2007 Leon Epstein Award for the Best Book published in the previous two years in the area of political parties and organizations, as well as the Best Book Award from the American Political Science Association’s Comparative Democratization Section. Her second book The Politics of Poverty Relief: Strategies of Vote Buying and Social Policies in Mexico (with Alberto Diaz-Cayeros and Federico Estevez) (Cambridge University Press, 2016) explores how politics shapes poverty alleviation.

Magaloni’s work was published in leading journals, including the American Political Science Review, American Journal of Political Science, Criminology & Public Policy, World Development, Comparative Political Studies, Annual Review of Political Science, Cambridge Journal of Evidence-Based Policing, Latin American Research Review, and others.

Magaloni received wide international acclaim for identifying innovative solutions for salient societal problems through impact-driven research. In 2023, she was named winner of the world-renowned Stockholm Prize in Criminology, considered an equivalent of the Nobel Prize in the field of criminology. The award recognized her extensive research on crime, policing, and human rights in Mexico and Brazil. Magaloni’s research production in this area was also recognized by the American Political Science Association, which named her recipient of the 2021 Heinz I. Eulau Award for the best article published in the American Political Science Review, the leading journal in the discipline.

She received her Ph.D. in political science from Duke University and holds a law degree from the Instituto Tecnológico Autónomo de México.

Director, Poverty, Violence, and Governance Lab
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Paula M. L. Moya Professor of English
Angela Garcia Associate Professor of Anthropology
Francisco Preciado Co-Moderator

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alberto_diaz-cayeros_2024.jpg MA, PhD

Alberto Díaz-Cayeros is a Senior Fellow at Stanford University's Freeman Spogli Institute for International Studies (FSI), and co-director of the Democracy Action Lab (DAL), based at FSI's Center on Democracy, Development and Rule of Law (CDDRL). His research interests include federalism, poverty relief, indigenous governance, political economy of health, violence, and citizen security in Mexico and Latin America.

He is the author of Federalism, Fiscal Authority and Centralization in Latin America (Cambridge, reedited 2016), coauthored with Federico Estévez and Beatriz Magaloni, of The Political Logic of Poverty Relief (Cambridge, 2016), and of numerous journal articles and book chapters.

He is currently working on a project on cartography and the developmental legacies of colonial rule and governance in indigenous communities in Mexico.

From 2016 to 2023, he was the Director of the Center for Latin American Studies at Stanford University, and from 2009 to 2013, Director of the Center for US-Mexican Studies at UCSD, the University of California, San Diego.

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Co-director, Democracy Action Lab
Director of the Center for Latin American Studies (2016 - 2023)
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The U.S. Preventive Services Task Force now recommends adults ages 40 to 75 with no history of heart disease — but who nevertheless have at least one risk factor and an elevated risk of cardiovascular disease — take a low- to moderate-dose statin.

The independent panel of experts in prevention and evidence-based medicine issued the recommendation in the Nov. 15 issue of JAMA.

An estimated 505,000 adults died of coronary heart and cerebrovascular disease in 2011. The prevalence of heart disease increases with, ranging from about 7 percent in adults ages 45-64 to 20 percent in those 65 and older. It is somewhat higher in men than in women.

Douglas Owens, MD, was a member of the task force when the guideline was developed. He is a professor of medicine at the School of Medicine and director of the Center for Health Policy and Center for Primary Care and Outcomes Research. The centers are part of Stanford Health Policy. He is also a physician with the Veterans Affairs Palo Alto Health Care System.

We ask Owens some questions about the new guideline:

Q: What prompted this new recommendation by the task force?

Owens: Cardiovascular disease is the leading cause of death in the United States, accounting for 1 in 3 deaths among adults due to heart attack and stroke. And statins can provide an important benefit to people at elevated risk of cardiovascular disease. But in order to know whether statins are going to be beneficial, it’s important to know something about the patient’s cardiovascular risk.

We reviewed the literature comprehensively — including 19 randomized clinical trials involving more than 73,340 patients, as well as additional observational studies — to understand both the benefits and the harms of statins. We concluded that the benefits outweigh the harms in appropriate patients at increased risk of cardiovascular disease. The primary benefit of statins is a reduction in your chance of having a heart attack or stroke.

Q: What are statins and why do they offer such benefit?

Owens: A statin is a drug that reduces the production of cholesterol by the liver. High cholesterol is a significant risk factor for cardiovascular disease and stroke, and statins help prevent the formation of the so-called bad cholesterol. Statin drugs also help lower triglycerides, or blood fats, and raise the so-called good cholesterol, HDL.

While there are some reported side effects from the use of statins, such as muscle and joint aches, most people tolerate statins fairly well. There is mixed evidence about whether statins may result in a modest increase in the chance of diabetes, but the task force assessed the benefits to clearly outweigh harms in patients at increased risk of cardiovascular disease.

 

 

Q: Who should be taking low- to moderate-dose statins?

Owens: The task force recommends that clinicians offer statins to adults who are 40 to 75 years old and have at least one existing cardiovascular disease risk, such as diabetes, hypertension, high cholesterol or smoking. They also must have a calculated risk of 10 percent or more that they will experience a heart attack or stroke in the next decade.

The task force recommends clinicians use the American College of Cardiology/American Heart Association risk calculator to estimate cardiovascular risk because it provides gender- and race-specific estimates of heart disease and stroke.

For people with a risk of 7.5 to 10 percent of heart attack or stroke over the next decade, the task force recommends individual decision-making, as the benefits of statins are less in this age group because these people have a lower baseline risk of having a cardiovascular event.

The task force also looked at the initiation of statins in people 75 or older and found there wasn’t enough evidence to determine whether people in this age group who have not previously been on a statin would benefit from starting a statin. So the task force suggests people in this age group consult their physicians about whether a statin may be beneficial.

Q: Do these new statin guidelines override the task force recommendation in 2008 that adults be screened for lipid disorders due to high cholesterol?

Owens: Yes, this recommendation replaces the 2008 recommendation on screening for lipid disorders in adults.

The accumulating evidence on the role of statins in preventing heart disease has now led the task force to reframe its main clinical question from “Who should be screened for dyslipidemia?” to “Which population should be prescribed statin therapy?”

We recommend that physicians go beyond screening for elevated lipid levels and assess the overall cardiovascular risk to identify adults ages 40 to 75 years who will benefit most from statin use.

Q: What does the task force hope to accomplish with the new recommendation?

Owens: We hope this guideline will help both clinicians and patients decide what their cardiovascular risk is and what steps they can take to reduce those risks, which include a healthy lifestyle, a healthy diet and exercise, and for appropriate patients at elevated risk for cardiovascular disease, potentially a statin. 

We also hope to highlight areas that would benefit from additional research. Further research on the long-term harms of statin therapy, and on the balance of benefits and harms of statin use in adults 76 years and older, would be helpful in informing clinicians and patients. 

 

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