Cholesterol Watch

Pharmacy Times, Volume 0, 0

National Effort to Control Kids? Cholesterol Warranted

Researchers at the University ofCalifornia, San Diego School of Medicineare proposing that aggressive interventionto lower cholesterol levels fromchildhood on is the best approach toreducing the occurrence of coronaryartery disease.

In a review article, published in theAugust 5, 2008, issue of Circulation, physician-researchers call current approachesto lowering cholesterol to preventheart disease "too little, too late." Thereis a large body of evidence provingthat low cholesterol levels are associatedwith low rates of heart disease and"?our long-term goal should be to alterour lifestyle accordingly, beginning ininfancy or early childhood."

The researchers do not advocate theuse of drug therapy to achieve lowcholesterol levels in the population atlarge. Instead, they suggest programs topromote therapeutic lifestyle changes,such as diet and exercise.

A national program to lower cholesterolcould be combined with governmentefforts to fight obesity anddiabetes.

"A concerted national effort mightdramatically reduce morbidity and mortalitydue to 3 major chronic diseases. Itwould take generations to achieve and itwould require an all-out commitment ofmoney and manpower to reeducate andmodify the behavior of a nation. Is thatimpossible? No. We have already shownthat even a frankly addictive behaviorlike cigarette smoking can be overcome(eventually)," wrote the authors.

Statins LowerStroke Risk in Seniors

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

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

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

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

Soy Has No Effecton Cholesterol

Regular consumption of soy protein had no significant effect onlow-density lipoprotein (LDL) cholesterol, according to recentstudy findings, despite the protein being promoted as a way tolower cholesterol.

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

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

Keep Taking Cholesterol Medicine After AMI

Individuals may want to rethink stoppingstatin medication because it failed toprevent an acute myocardial infarction(AMI). Canadian researchers found thatsurvivors of heart attacks who quit takingcholesterol-lowering medicines weremore prone to die during the followingyear, compared with individuals who hadnever been on the drugs.

The study looked at British patientswho had survived a heart attack and werestill alive 3 months later. The researchersfound that about 30% of patients prescribeda statin ceased taking it withinthe first year. Patients who used statinsbefore a heart attack and continued theiruse after were 16% less likely to die overthe next year.

"Because statins are preventive drugs,patients may not feel the immediate benefitof taking them and sometimes stop.However, it looks like it might be quite adangerous practice after an AMI," said researcherStella Daskalopoulou, MD, PhD.

Dr. Daskalopoulou said it was unclearwhy those who continued taking theirstatins did better. "Regardless of themechanism or explanation, physiciansshould be careful when assessing eachpatient's medication needs."

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