CHOLESTEROL WATCH

Pharmacy Times, Volume 0, 0

Premature Birth, High Cholesterol Link Found

Women who give birth early appearto increase their risk of having cholesterolproblems later in life, accordingto findings presented recently at theSociety for Gynecologic Investigation.

The current study compared 47 womenwho had a preterm birth, definedas giving birth before 37 weeks ofgestation, with 104 women who gavebirth to full-term infants. A majorityof women in the preterm group gavebirth prior to 34 weeks of gestation.Cholesterol was measured from bloodsamples taken an average of 7.4 yearsafter delivery.

The researchers found that womenwho had given birth before 34 weeks ofgestation had the highest levels of totalcholesterol at 202.6 mg/dL. Womenwho had given birth between 34 and37 weeks had levels of 190.1 mg/dL,and women who had full-term babieshad levels of 180.1 mg/dL. After takinginto account race, smoking history,and body mass index, the researchersdetermined that women who had apremature birth had a 2.3 times higherrisk of developing cholesterol levelsabove 240 mg/dL. Furthermore,these women were 3.3 times more likely tohave elevated low-density lipoprotein,compared with women who gave birthto full-term babies.

ALS Survival: High Lipid Levels

French researchers have found that hyperlipidemiaseems to considerably affect survival in patients withamyotrophic lateral sclerosis (ALS; often referred to asLou Gehrig?s disease), according to a study reportedrecently in Neurology.

The study involved blood samples from 369 patientswith ALS and 286 healthy participants. Theresearchersdiscovered that elevated lipid levels, asseen by increased blood levels of total cholesterol orlow-density lipoprotein (LDL; the "bad" cholesterol),were twice as common in patients with ALS, comparedwith the control group. The results also indicatedthat patients with ALS with a low ratio of LDL tohigh-density lipoprotein (the "good" cholesterol) faceda 35% increased risk of death. The median survival inthose with the highest ratio was 49 months, comparedwith 36 months in those with the lowest ratio.

"These results," said study author Vincent Meininger,MD, PhD, "raise the question of using a fat diet forALS patients, and to avoid using cholesterol-loweringdrugs?mainly statins."

Study Tests Aggressive Cholesterol, BP Therapy

Researchers did not get a definitive answer on whether aggressivelylowering cholesterol levels and blood pressure in individuals at greaterrisk for heart disease is worth the effort, according to a study reportedin the April 9, 2008, issue of the Journal of the American MedicalAssociation. The study of 499 American Indians with diabetes found thatthe approach led to some improvements without resulting in dangerousside effects.

"This is the first trial that really tested targeting," said lead authorBarbara V. Howard, PhD. "Until now, clinical trials have meant taking adrug and escalating the dose and comparing the reduction in heart disease.Our goal was to target people at high risk and test lower targets forboth risk factors hypertension and LDL [low-density lipoprotein] cholesterol.What we showed is that you can reach those lower targets safely."

Researchers found a reduction in the thickening of the walls of thecarotid artery. No difference in the rate of adverse events was indicatedbetween the participants who had the most aggressive treatment andthe participants who had the standard treatment, however. "But therehave been no trials where the carotid measurements did not correlateeventually with what happened in the end points," she noted.

Dr. Howard concluded that "we see improvement with lower targets,but we need longer studies."

High Cholesterol in MidlifeUps Dementia Odds

Middle-age individuals with elevated cholesterol levels mayup their risk of developing Alzheimer?s disease decades later.The findings, presented recently at the American Academy ofNeurology, reinforce the importance of health factors in individualsin their 40s on the risk of dementia.

The study showed that those with high cholesterol betweenthe ages of 40 and 45 were about 50% more prone to laterdevelop the brain ailment, compared with individuals with lowcholesterol. "Cholesterol is just one piece of the puzzle. Thereare other risk factors like hypertension and obesity. The morerisk factors you have, the higher the risk gets," said researcherAlina Solomon, MD.

She noted that earlier research had evaluated the issue ofhigh cholesterol levels in middle age as a risk factor for laterdevelopment of dementia but did not focus exclusively onAlzheimer?s disease.