Cholesterol drugs for other issues

Published Wednesday, June 10, 2009

DEAR DR. DONOHUE: My doctor wants me to take a statin drug even though my total cholesterol is normal and my LDL cholesterol isn't very high. The only other abnormal test was the CRP test. He says that a statin for someone like me has been shown to prevent heart attacks. My father died of one at age 42. I don't relish taking pills. What are your thoughts? -- L.F.

ANSWER: We are overmedicated, especially older people who see more than one doctor. That's true. But new information is proving to be a strong stimulus for prescribing statin medicine. Statin drugs -- Crestor (rosuvastatin), Zocor (simvastatin), Lipitor (atorvastatin), Lescol (fluvastatin) and Pravachol (pravastatin) -- are the most effective cholesterol-lowering drugs available. A recent study has demonstrated that these drugs also lessen body inflammation, a relatively new aspect in the search for a cause of heart attacks and strokes.

Body inflammation disrupts plaque, the buildup of cholesterol and other materials in and on the artery wall. When that happens, the ruptured plaque attracts platelets, which form a clot within the artery. The clot blocks blood flow and leads to either a heart attack or a stroke, depending on whether the involved artery is a heart or brain artery. This is the mechanism most often involved in these incidents.

It turns out that statin drugs not only take care of cholesterol, but they also reduce inflammation, so they are a doubly effective prevention of heart attacks and strokes. The study I refer to is the Jupiter Study, which showed that people taking a statin were 48 percent less likely to suffer a heart attack and 50 percent less likely to have a stroke. So, how are we supposed to react to this? People at high risk for either heart attack or stroke are already taking a statin. People at low risk don't need one. But people in between -- a sizable number -- are the ones who can benefit from this double action of statins. These people have a high C-reactive protein, a blood test that demonstrates body inflammation. They are candidates for statin therapy even if their cholesterol numbers are not so bad.

Your doctor must feel you belong to the group of people who would be well-served by statins' dual action.

StAugustine AllAccess

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