Pharmacy Times

Cholesterol Watch

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National Effort to Control Kids? Cholesterol Warranted

Researchers at the University of California, San Diego School of Medicine are proposing that aggressive intervention to lower cholesterol levels from childhood on is the best approach to reducing the occurrence of coronary artery disease.

In a review article, published in the August 5, 2008, issue of Circulation, physician-researchers call current approaches to lowering cholesterol to prevent heart disease "too little, too late." There is a large body of evidence proving that low cholesterol levels are associated with low rates of heart disease and "?our long-term goal should be to alter our lifestyle accordingly, beginning in infancy or early childhood."

The researchers do not advocate the use of drug therapy to achieve low cholesterol levels in the population at large. Instead, they suggest programs to promote therapeutic lifestyle changes, such as diet and exercise.

A national program to lower cholesterol could be combined with government efforts to fight obesity and diabetes.

"A concerted national effort might dramatically reduce morbidity and mortality due to 3 major chronic diseases. It would take generations to achieve and it would require an all-out commitment of money and manpower to reeducate and modify the behavior of a nation. Is that impossible? No. We have already shown that even a frankly addictive behavior like cigarette smoking can be overcome (eventually)," wrote the authors.


Statins Lower Stroke Risk in Seniors

Seniors who take cholesterol-lowering medication after a stroke or mini-stroke lower the risk of another stroke, according to the study published online in the September 3, 2008, issue of Neurology.

For the study, the researchers looked at 4731 individuals who had a recent stroke or mini-stroke, including 2249 individuals aged 65 and older and 2482 individuals under age 65. In each group, about 50% of the patients received the statin drug atorvastatin, and about half received a placebo.

The findings showed that levels of low-density lipoprotein cholesterol were reduced by an average of 61 points in the senior group and by an average of 59 points in the under-65 group. The risk of stroke was lowered by 26% in the younger group and by 10% in the older group.

"It's estimated that 20% of the US population will be 65 and older by 2010, so it's important that we identify ways to reduce the burden of strokes and other cerebrovascular disease in this group," said study author Seemant Chaturvedi, MD.


Soy Has No Effect on Cholesterol

Regular consumption of soy protein had no significant effect on low-density lipoprotein (LDL) cholesterol, according to recent study findings, despite the protein being promoted as a way to lower cholesterol.

The findings "do not support the current health claims for soy protein in a general population," said study author Peter R.C. Howe, PhD. He is referring to the health claims approved for soy food both in the United States and the United Kingdom that associate daily consumption of 25 g of soy protein to a reduction in heart disease risk through lowering of LDL cholesterol.

For the study, the researchers looked at 35 men and 58 women who had mildly high cholesterol levels. Each participant was assigned to rotate through 1 of 3 diets for 6 weeks each. The researchers measured each participant's blood cholesterol at study onset and after each 6-week diet. The findings, published in the August 2008 issue of The American Journal of Clinical Nutrition, found no considerable effect of the diets with either 24 g or 12 g of soy protein on LDL levels.


Keep Taking Cholesterol Medicine After AMI

Individuals may want to rethink stopping statin medication because it failed to prevent an acute myocardial infarction (AMI). Canadian researchers found that survivors of heart attacks who quit taking cholesterol-lowering medicines were more prone to die during the following year, compared with individuals who had never been on the drugs.

The study looked at British patients who had survived a heart attack and were still alive 3 months later. The researchers found that about 30% of patients prescribed a statin ceased taking it within the first year. Patients who used statins before a heart attack and continued their use after were 16% less likely to die over the next year.

"Because statins are preventive drugs, patients may not feel the immediate benefit of taking them and sometimes stop. However, it looks like it might be quite a dangerous practice after an AMI," said researcher Stella Daskalopoulou, MD, PhD.

Dr. Daskalopoulou said it was unclear why those who continued taking their statins did better. "Regardless of the mechanism or explanation, physicians should be careful when assessing each patient's medication needs."

F A S T   F A C T: Statin use increased by 156% between 2000 and 2005.