Statin drug gets support in reducing high cholesterol
Heart Specialists released new guidelines in mid-November that could change the way physicians and patients deal with high cholesterol.
The guidelines suggest that more people would benefit if they started or continued to take the statin drugs. This class of drug is designed to reduce cholesterol in the blood by limiting its production in the liver.
Cholesterol is important in normal cell function, but too much causes atherosclerosis. That’s when cholesterol-laden plaques are formed and stick to the walls of blood vessels. This narrows the vessel, restricting blood flow. Reduced blood supply to the heart can cause pain or a heart attack. Reduced flow of blood to the brain can result in a stroke. Statins may reduce the formation of new plaque in the vessels and can occasionally reduce the plaques already there. They also can stabilize those plaques and make them less prone to creating clots in the vessels.
The changes affect how doctors and their patients take stock of cholesterol risk in their patients. Now instead of using elevated levels of bad cholesterol, or LDL, to trigger the prescription of statins, the new treatment calls for getting out in front of the LDL levels. It also takes into account the risk that a patient might have a stroke. People from 40 to 75 years old who are determined to have a 7.5 percent risk of heart disease within a ten-year period will also be candidates for statin therapy.
People will be advised to take statins if they have been diagnosed with heart disease, if they are middle-aged and have Type 2 diabetes, or if they have an LDL level higher than 190 milligrams per deciliter of blood.
Specialists from the American Heart Association and the American College of Cardiology studied data on heart disease treatment for four years before publishing the new guidelines. “We focused specifically on the use of cholesterol-lowering therapy to determine what works best to reduce the risk of heart attack and stroke,” Dr. Neil Stone, chairman of the cholesterol committee and a professor of medicine at Northwestern University Feinberg School of Medicine, said during a news conference. Dr. Hector Medina, a cardiologist at Scott & White Healthcare in Round Rock, Texas, told HealthDay in a recent interview that the new protocol “suggests treatment should be individualized and that, depending on your risk, you may need a higher dose of a more potent statin than if your risk is lower.”
Statins like Crestor, Lipitor and Zocor are considered the most effective drugs for reducing cholesterol levels in patients, along with proper diet and exercise. The study asserts that determining a patient’s proper dosage of the statins is more important that achieving any specific target LDL level. Up to now, doctors have used certain LDL and HDL levels to trigger drug therapy. HDL is sometimes called “good cholesterol.”
The report goes on to state about 33 percent of adults are at risk for a heart attack or stroke and have not been diagnosed. This group would benefit from preventive measures, including taking statins. The risk factors most often used by physicians are age, cholesterol levels, blood pressure, diabetes and tobacco use. Dr. Donald Lloyd- Jones, a professor of preventive medicine at the Northwestern University Feinberg School of Medicine and co-chairman of the committee, said at the news conference, “These are the strongest predictors of 10- year risk for cardiovascular disease.” He said people with those risk factors should immediately begin drug therapy and change their lifestyle.
Dr. Timothy Henry, director of cardiology at the Cedars-Sinai Heart Institute told WebMD, “The new focus is on risk rather than simply a cholesterol number.” He emphasized the new report does not mean the previous treatment methodology was incorrect. “Nothing was wrong, [it’s] just a different approach or focus. Rather than numbers, it’s moving the focus to understanding risk and with a focus on a heart-healthy lifestyle.”
Dr. Robert Eckel, professor of medicine at the University of Colorado was also a member of the cholesterol guidelines panel. He told WebMD the drug manufacturers had no part in the new recommendations. “People [on the panels] who felt they were conflicted did not vote on the guidelines,” he said.
Weight-related issues did not escape the panel’s evaluation, either. “Our recommendation is that doctors prescribe a diet to achieve reduced caloric intake as part of a comprehensive lifestyle intervention,” said Dr. Donna Ryan, a professor emeritus at Louisiana State University’s Pennington Biomedical Research Center in Baton Rouge and a co-author of the new guidelines. The diet should take into account patient preferences and any drugs they take, she said.
As with any medical issue, the best source of information is your personal physician.
– Joe Todaro
