Friday, November 19, 2010

Good and bad news about cholesterol lowering drugs....

Today's Post: Friday, 11-19-2010

A. There were two pieces of news this week about cholesterol lowering drugs.

1. One said that statin drugs were significantly over-prescribed to people unlikely to get almost any benefits. People who had already survived a heart attack etc or who had a lot of calcified plaque did benefit somewhat by taking statins. But people with neither did not.

2.The other news was a good bit more promising. A new Merck drug, anacetrapib, given to people already taking statin drugs boosted HDL 62 points! And, it lowered LDL an additional 32 points. The article I saw did not list the changes if any in triglycerides or the HSCRP measure of the inflammatory marker, C reactive protein.

But the lipid lipoprotein (a), that is a measure of the likelihood of plaque forming in your blood vessels just about was cut in half.

It also did not cause the negative heart impacts or the boosted blood pressure a drug in the same class did earlier.

If in upcoming the larger scale 4 year test, it doesn’t cause other bad side effects and delivers heart attack prevention and blood flow improvement benefits, it may well replace statins or always be used with them for very high risk patients.

B. This does ignore the fact that NOT smoking or getting second hand smoke; regular, vigorous exercise; upgrading from junk food, soft drinks, sweet treats, and snacks to what writer Michael Pollan calls real food; and taking quite modest amounts of niacin, inositol hexaniacinate, and sterol supplements delivers comparable heart protective readings and protection. This set of lifestyle upgrades also dramatically lowers triglycerides, which we now know means that it lowers the level of the small particle LDL that causes heart disease.

AND, it also delivers dozens of other health benefits from losing excess fat to lowering blood pressure and blood sugar if they were too high and cancer protection.

Further, these lifestyle upgrades do NOT cause the side effects of statins.

These changes, unlike statin drugs have been dramatically underused and undersold to people wanting to prevent heart attacks

C. Where do we go from here?

1. What do we do about deciding if people with low HDL or high LDL should take statin drugs?

a) If the person has already had a CAT scan of their heart area which found a lot of calcified arterial plaque or they have already had a heart attack indicating they likely have calcified plaque, it may be worth giving them statin drugs.

But even then, they should have the Berkeley Heart Lab tests. The researchers there have used their tests to find several subtypes of heart risk. Only one kind of the many they find gets more protection from statin drugs. All the rest do far better by taking niacin.

So, even here, statins are over-prescribed!

b) If they have neither had a CAT scan of their heart area nor a heart attack etc, what can be done?

Getting a CAT scan to check the calcification of their arteries is likely NOT a wise choice despite being quite diagnostic. It subjects them to the radiation of thousands of more reasonable medical X-rays & is quite expensive to do.

If they smoke or have a lot of exposure to second hand smoke or have truly dreadful readings indicative of unusually high risk, it might make sense to have them take the Berkeley Heart Lab tests.

c) But by far the most important thing to do in all cases is to let them know that that NOT smoking or getting second hand smoke; regular, vigorous exercise; and upgrading from junk food, soft drinks, sweet treats, and snacks to what writer Michael Pollan calls real food is by far their best protection and is their number one priority.

And, they should try lower doses of niacin and inositol hexaniacinate, and take sterol supplements before considering statin drugs or mega doses of niacin. These supplements are far safer and have far fewer side effects and they work quite effectively, particularly when combined with the lifestyle upgrades.

Only if they are unable or unwilling to make these lifestyle upgrades and, in the Berkeley Heart Lab tests, test as being in the class of people who do well on statins, should they be prescribed statin drugs in my opinion.

2. The good news is that the new Merck drug that tests much like a super-niacin may be helpful for many people as they gear up these lifestyle upgrades or who can’t or won’t do them or who are initially at very high risk.

But the lifestyle upgrades should be the number one choice NOT statin drugs.

These lifestyle upgrades do much more to protect health than just heart protection if they are all done and done well.

In fact, with statin drugs, only the people who also do these lifestyle upgrades get any significant heart protection. And, if the people who might take statin drugs do these lifestyle upgrades for 6 months and get re-tested, most of them will no longer be candidates for statin drugs.

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Blogger David said...

Important upgrade.

This post highlights the danger to your heart from getting calcified plaque in your arteries.

Other recent news reported that taking calcium supplements can increase the risk of heart disease and heart attacks about 30 %.

This seems to be by increasing the calcification of the plaque in your arteries.

Further this seemed to be worse if the calcium was taken at times other than just after eating and dumped too much into your blood vessels too fast to be processed properly.

Second, it makes no sense to take calcium for stronger bones unless you do it with the other things that make it effective such as taking at least 2,000 iu a day of vitamin D3, getting weight bearing exercise, and NOT drinking soft drinks -- particularly colas.

And, the following is also likely wise.

Only take a miniumum amount of calcium supplements. Get most of your calcium in foods. And, if you do take any calcium supplements, take them just after eating to allow your body to process the calcium gradually instead of dumping into your blood where it makes your plaque calcify.

3:49 PM  
Anonymous Winstrol said...

There should be more articles like this one on the web. Very well written, lots of useful information. Greetings and thanks for sharing.

5:11 AM  

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