Statins may perform better as a solo act

Statins may do their best work at lowering cholesterol levels alone, according to a new review of research on the popular drugs. More than 28 million Americans have some form of heart disease, and doctors often prescribe statin drugs to lower dangerous low-density lipoprotein (LDL) cholesterol levels. High LDL cholesterol levels increase the risk of arteries becoming blocked and triggering a heart attack or stroke. Even so, researchers say only about one-third of people with high cholesterol are able to lower their LDL cholesterol to healthy levels and that number is even lower among those with established heart disease. That prompts many doctors to try combining cholesterol-lowering statin therapy with other non-statin medications in an attempt to further lower cholesterol levels. But researchers analyzed 102 published studies on the topic and found no benefit of combination therapy at reducing the risk of death, heart attack, stroke, or the need for bypass surgery over using high doses of statins alone. The studies were of relatively short duration, often did not employ maximal doses of statin drugs in the combination regimens, and did not examine all possible medication combinations. These limitations affect the ability to make firm conclusions regarding the true use of combination therapy. Nevertheless, the proven benefits of using statin drugs alone in reducing the risk of heart attack and stroke suggest that 'the benefits of additional therapies need to be clearly defined along with attendant risks and costs before advocating widespread use of combination treatment,' writes researcher Mukul Sharma, MD, MSc, of the Canadian Stroke Network in the Annals of Internal Medicine. - WebMD

Livalo, a new statin, gets FDA nod

"The FDA has approved a Livalo, a new cholesterol-lowering statin drug. Known by the generic name of pitavastatin, Livalo has been used in Japan since 2003. It's also sold in Korea and Thailand. Livalo is made by the multinational Japanese firm Kowa Company Ltd. Kowa now has facilities in the U.S." - WebMD

One in three people over 45 'now take statins to reduce heart attack risk' (UK)

"Official figures show there are more than 7 million people in England taking the cholesterol-lowering drugs to reduce their risk of suffering a heart attack. It has raised concerns over the medicalisation of a generation as the numbers on statins are set to increase even further as the Government's new health checks for the over-40s take effect. Prescriptions for antidepressants and drugs for obesity and attention deficit disorder have also risen by up to ninefold in 10 years" - Telegraph

Statins may drain energy

Statins, taken by 13 million Americans to lower cholesterol, may also drain energy levels:

Should even the healthy take statins?

"Preventive medicine focuses on encouraging the general public to worry about illnesses that they will probably never develop, and on doctors to search for remedies that they may never need. But it saves lives. The number of British men and women dying prematurely from heart attacks has fallen by almost a third over the past decade and much of the credit must go to the increasingly widespread use of the statin family of cholesterol-lowering drugs. Statins are taken by millions of people in the UK and are one of the key ingredients in the polypill (a collection of five different drugs being developed as a cardiovascular panacea for anyone over the age of 55). The Department of Health estimates that statins prevent about 10,000 early deaths every year, but a small and vocal group of sceptics believes that they are not as effective as claimed and that they cause a number of disabling side-effects" - Times

Cholesterol contrarians question cult of statins

"The swell of support for broad use of the cholesterol-lowering drugs known as statins have some medical researchers fearing that side effects we already know about suggest the drugs are too little understood" - Miller–McCune

Rockefeller University Hospital opens clinical trial into statin-associated muscle complaints

"The most widely prescribed class of drugs in the country, statins have helped millions of people lower their cholesterol and reduce their risk of heart attacks - but their side effects, including muscle pain and cramping, have proven to be something of a sore point for many patients. Now, researchers at The Rockefeller University Hospital aim to determine the cause of statin-associated myopathy in a new clinical study. Patricia Maningat, instructor in clinical investigation in Rockefeller's Laboratory of Biochemical Genetics and Metabolism, is the study's principal investigator. Approximately 38 million people in the United States are on statins, and medical professionals expect the number to continue rising. About 10 percent of patients taking statins report some level of myopathic symptoms, but the only marker known to gauge them - elevated blood levels of an enzyme known as creatine kinase - often shows up normal, creating diagnostic confusion and leaving many muscle complaints undiagnosed" - Newswire

High-dose statin before PCI decreases periprocedural MI risk

Loading or reloading with high-dose atorvastatin reduces the risk of periprocedural myocardial infarction (MI) and vascular events in patients undergoing elective percutaneous coronary intervention (PCI), according to data presented at the American College of Cardiology 58th Annual Scientific Session. In a loading study, atorvastatin 80 mg administered within 24 hours of PCI to statin-naïve patients reduced the risk of periprocedural non-Q-wave MI by 44%, reported Carlo Briguori, MD, PhD, of Clinica Mediterranea, Naples, Italy. Up to 30% of untreated patients have increases in troponin and creatine kinase-myocardial band (CK-MB) levels after stent implantation, Dr Briguori said. In this study, 668 statin-naïve patients scheduled for elective PCI were randomized to receive either atorvastatin 80 mg or placebo.

Study: Cholesterol drug lowers blood clot risk

Statin drugs, taken by millions of Americans to lower cholesterol and prevent heart disease, also can cut the risk of developing dangerous blood clots that can lodge in the legs or lungs, a major study suggests. The results provide a new reason for many people with normal cholesterol to consider taking these medicines, sold as Crestor, Lipitor, Zocor and in generic form, doctors say. In the study, Crestor cut nearly in half the risk of blood clots in people with low cholesterol but high scores on a test for inflammation, which plays a role in many diseases. This same big study last fall showed that Crestor dramatically lowered rates of heart attacks, death and stroke in these people, who are not usually given statins now. "It might make some people who are on the fence decide to go on statins," although blood-clot prevention is not the drugs' main purpose, said Dr. Mark Hlatky, a Stanford University cardiologist who had no role in the study. Results were reported Sunday at the American College of Cardiology conference and published online by the New England Journal of Medicine - Yahoo

A possible risk group for statin use

"In a patient study of over 1,000 individuals with coronary artery disease, researchers have found that high levels of an enzyme called PLTP significantly increased the risk of heart attack in the subset of patients taking statins. While follow-up studies will be needed to tease out the exact connection between PLTP and statins, this connection does suggest levels of PLTP in the blood should be a consideration for potential statin treatment" - Physorg.com

$29 billion reasons to lie about cholesterol - book

$29 Billion Reasons to Lie about Cholesterol: Making Profit by Turning Healthy People into Patients by Justin Smith. "We are told that high cholesterol levels pose a major risk factor for developing heart disease. We are also told that the consumption of foods containing saturated fat and cholesterol increases the risk for heart disease - the Cholesterol Idea. This idea has led to the mass prescription of cholesterol-lowering drugs, but do so many of us really need these drugs and what are the risks associated with lowering cholesterol?"

AHA: statins may drain energy along with cholesterol

Statins effectively reduce low-density lipoprotein (LDL) cholesterol, but they also appear to reduce patients' levels of energy and activity, according to research presented at the American Heart Association's 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention. Beatrice Golomb, M.D., of the University of California San Diego, and colleagues randomly assigned 1,016 adults who were free of diabetes or heart disease but had LDL levels between 115-190mg/dL to receive either simvastatin, pravastatin or placebo for six months. They assessed energy and activity at baseline on scales of 0-10 and again on follow-up, with a score of -2 indicating "much worse" and a score of +2 indicating "much better." The researchers found that simvastatin was associated with a greater mean LDL reduction than pravastatin (49 mg/dL versus 40 mg/dL). Compared to placebo, however, they found that pravastatin was associated with a significantly higher proportion of patients who rated both their energy and activity levels as "much worse" and that simvastatin was associated with a significantly higher proportion of patients who rated their energy level as "much worse." "Future studies should extend evaluation to higher statin doses; and include assessment of measured activity," the authors conclude. - Modern Medicine

Statins may keep asthma patients out of ER - study

Asthma sufferers taking statins in addition to their regular medicine required significantly fewer trips to the hospital, according to a study the provides the latest suggestion of added benefits from the widely-used cholesterol lowering drugs. Among adults on inhaled corticosteroids in the 6,574-patient study, those also taking statins reduced their chances of an asthma-related hospitalization or emergency room visit by 33 percent, according to data presented at the American Academy of Asthma, Allergy and Immunology meeting in Washington on Saturday. The study was conducted by researchers from Medco Health Solutions Inc. and Boston's Brigham and Women's Hospital - Reuters

Statins could hurt your sex life

Statins are great at helping to lower cholesterol, but there's a catch, a new study suggests: The better they work at lowering cholesterol, the more sexual pleasure is reduced. The six-month, government-funded study involved more than 1,000 adults with high LDL -- "bad cholesterol" -- but no heart disease. Participants took either a statin or a placebo. In the study, the ability to have an orgasm dropped along with LDL levels, said study leader Beatrice Golomb of the University of California-San Diego School of Medicine. Patients who took simvastatin, or Zocor, had the biggest LDL drop, but men rated their sexual pleasure as sinking by nearly half over the study period. Women were somewhat better off, "but some definitely were affected," Golomb said. Pravastatin, or Pravachol, reduced LDL less and didn't have a significant effect on orgasms. The study was presented at a conference of the American Psychosomatic Society in Chicago last week. The findings should spur doctors to routinely ask patients about changes in sexual pleasure, said Dr. Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital. - Sun-Times

The Great Debate...Should Everybody Take Statins?

Statins, the new wonder drug. Or, maybe not. Cholesterol-lowering statins are among the most prescribed medications in the world and the suggestion has been made that just about everybody ought to take them. There's no doubt they work to lower cholesterol and reduce the risk of heart attack or stroke in high risk populations. But the debate continues on the advisability of widespread statin use by a more general population. Two University of Alabama at Birmingham physicians will join the fray when they face off in the second UAB Great Debate. Sponsored by the UAB Lung Health Center, the statin debate will feature Vera Bittner, M.D., professor of medicine in the division of cardiovascular disease, arguing for expanded statin use, against Gustavo Heudebert, M.D., professor of medicine in the division of internal medicine, who will defend the position of those who call for restraint. The debate will be at noon on April 8, in Spain Auditorium. The inaugural Great Debate was held in 2008, when Mark Dransfield, M.D., and Robert Cerfolio, M.D., squared off over the benefits of lung cancer screening. The success of that event spurred the continuation of the series. "It seems to me that the best opportunity to learn about controversial issues is to hear people on each side of the issue defend their position," said William Bailey, M.D., professor of pulmonary, allergy and critical care medicine who organized the Great Debate. "Statins are one of the more controversial issues in medicine today and the Great Debate creates a unique environment for physicians to learn together." Researchers are probing whether statins also may be helpful for conditions such as COPD, inflammation, dementia, cancer, cataracts and hypertension. - insciences.org

Statins help elderly as well as young after stroke

Elderly people who've suffered a recent stroke benefit almost as much from treatment with a "statin" drug as do younger stroke patients, researchers report in the medical journal Neurology. The cholesterol-lowering statins reduce the risk of heart disease. A study called SPARCL (for Stroke Prevention by Aggressive Reduction in Cholesterol Levels) was performed to see if statins also reduced stroke risk. The study compared the risks and benefits of taking high-dose atorvastatin (brand name Lipitor) versus an inactive placebo for patients who had recently had a stroke or a so-called TIA, or transient ischemic attack. TIAs are sometimes called mini-strokes, but experts say the condition is far from trivial. - Reuters

Statins: "Wonder drug that stole my memory" (UK)

Statins have been hailed as a miracle cure for cholesterol but little is known about their side effects. Christopher Hudson, from Kent, UK, describes his loss of memory while taking statins - The Telegraph

Non-LDL statin effects credited with improving stroke functional outcomes

Among patients presenting to the emergency department with ischemic stroke in a prospective cohort study, those with LDL cholesterol in the normal range thanks to statin therapy were later discharged in a significantly better functional state than those who had normal baseline LDL-C levels without the help of statins. The findings, which were independent of patient age, sex, and stroke severity, are consistent with observational evidence that stroke outcomes are improved in patients already on statins. But they go a step further by suggesting that at least some of those benefits are due to non-LDL-lowering effects of the drugs, according to the authors, led by Dr Latha G Stead (University of Rochester Medical Center, NY). Their report appears in the March-April 2009 issue of the Journal of Stroke and Cerebrovascular Diseases.

Statins trial could benefit rheumatoid arthritis sufferers (UK)

Part of a major UK trial to find out if taking statins could reduce the number of rheumatoid arthritis patients dying of heart attacks and strokes is to be opened in Belfast. According to the Arthritis Research Campaign (ARC), rheumatoid arthritis patients have an increased risk of dying from cardiovascular complications compared to the general population - but few are routinely prescribed the cholesterol-lowering drugs, statins. The charity is urging eligible RA patients registered with Musgrave Park Hospital in Belfast to join almost 4,000 people involved in a UK-wide five-year GBP1.1m trial. While based at the University of Manchester, the trial will involve more than 60 rheumatology departments throughout the UK. It is being funded by ARC and the British Heart Foundation. - Belfast Telegraph

What's the evidence for statins?

"Many studies show that statins can help prevent heart attacks in people with coronary artery disease. Most people get unstable angina because of this disease. Studies also show they can lower the risk of stroke. However, not many studies have looked specifically at taking statins soon after an attack of unstable angina. We found one study with more than 3,000 people who were in hospital because of a mild heart attack or unstable angina. Some started taking a statin and others took a dummy treatment (a placebo). After 16 weeks, those who were taking the statin were less likely to have made another emergency trip to hospital for a similar heart problem" - Guardian/BMJ

Prescribing: GPs divided over statins for healthy patients

"Doctors are split over the benefits of offering statins to healthy people, according to an international survey. The results come as the DoH considers increasing the number of people who receive the drugs for the prevention of cardiovascular disease. England's national director for heart disease and stroke Professor Roger Boyle has said NICE will review whether more patients should receive them. The online poll of 2,553 readers by the New England Journal of Medicine found 48 per cent believe the therapeutic use of statins in healthy people should be changed based on results of the JUPITER trial" - Healthcare Republic