Cholesterol Watch

Pharmacy Times
Volume 75
Issue 6

New Prescribing Criteria May Prevent Heart AttacksStatins may lower the risk of heart attacks in millions of individuals who have low cholesterol but elevated levels of C-reactive protein (CRP), reported researchers in the March 17, 2009, issue of the Journal of the American College of Cardiology.

A study published last year found that statins protect against heart attack and stroke in older adults with low cholesterol but high levels of CRP. To find out how many individuals with low cholesterol (<130 mg/dL) and high CRP levels would benefit from statins, the current study analyzed data from the National Health and Nutrition Examination Survey.

The researchers concluded that 6.5 million older adults with lower cholesterol and high CRP might benefit from statins. The number would increase to 10 million if the cutoff was 160 mg/dL.

"We're showing that doctors may be able to prevent thousands of heart attacks, strokes, and deaths each year if we expand statin-prescribing criteria to include C-reactive protein levels, something we can assess as part of a simple blood test," said researcher Erin D. Michos, MD.

Study Links Statins with FatiguePatients taking statins may feel more tired, compared with those not taking the cholesterol-lowering medicine. The study, however, does not prove that the medications make people feel fatigued, and cardiologists remain skeptical.

"There is not sufficient evidence that statins cause fatigue," said Gregg C. Fonarow, MD, professor of cardiology at the University of California, Los Angeles.

The researchers divided 1016 adults without heart disease or diabetes into 3 groups and gave them daily doses of 20 mg of simvastatin, 40 mg pravastatin, or a placebo for 6 months. Beatrice Golomb, MD, PhD, who presented the study at the recent meeting of the American Heart Association, said that the patients taking simvastatin reported lower energy and activity levels, whereas those on pravastatin reported reduced energy levels only. On average, Dr. Golomb said that the patients who took the statins reported energy levels that were 5% lower than those who took a placebo.

Statins Beneficial for StrokeStatins can reduce the risk of stroke in patients of any age, according to findings reported in the February 24, 2009, issue of Neurology. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels study compared the risks and benefits of taking high-dose atorvastatin with an inactive placebo for patients who had recently had a stroke or a transient ischemic attack (TIA).

The study included about 2250 patients who were at least 65 years old and 2500 who were younger than 65. The findings showed that the occurrence of a fatal or nonfatal stroke was lowered by 26% in the younger group with atorvastatin, compared with placebo, and by 10% in the senior group. Furthermore, the researchers noted that the high-dose atorvastatin regimen was well tolerated by both patient groups.

"Clinicians should strongly consider using statins poststroke or TIA regardless of age," concluded lead researcher Seemant Chaturvedi, MD.

Strawberries Good for CholesterolNew research points to strawberries in helping reduce cholesterol damage. The small study looked at 28 men and women with high cholesterol who had been eating a low cholesterol diet.

During the month-long study, the researchers gave half of the group 3 cups of strawberries daily and the other half were given oat bran bread. The findings indicated that the participants who ate the strawberries maintained lower cholesterol but also had a reduction of "oxidative damage to LDL [low-density lipoprotein] cholesterol." In excess, LDL ("bad") cholesterol is damaging to the arteries, but it is even more dangerous if it is oxidized. The antioxidants in the strawberries help lower the free radicals that cause oxidation in the body.

More Education on Trans Fats NeededA survey tested 1000 adults on their knowledge of artery-clogging trans fats, and 92% reported that they had heard of them. In addition, almost 75% knew that trans fats may up the risk of heart disease.

The respondents, however, were unclear on foods with trans fats to avoid. Only 21% were able to name 3 food sources. Trans fats not only raise low-density lipoprotein ("bad") cholesterol but also lower levels of high-density lipoprotein ("good") cholesterol. The findings were reported in the February 2009 issue of the Journal of the American Dietetic Association.

FAST FACT: More than 27 million Americans have high levels of triglycerides (≥200 mg/dL).

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