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More Good News About Statins
Over 20 million Americans use statins to help reduce the risk of heart attack and stroke. With long-term use, these drugs, including such common brand names as Lipitor, Zocor, Pravachol, and Crestor, can reduce heart attack and stroke risk by 25 percent or more. Although our lifestyles are unhealthier than ever, heart attack rates are dropping thanks in large part to these pharmaceuticals.
The History of Statins
The first statin, Mevacor (lovastatin), was introduced in 1987, just one year before I finished medical school. This drug, derived from a fungus, was initially reserved only for those with extremely high cholesterol levels. That generally meant an LDL (bad) cholesterol level over 160 mg/dL.
Over the past 25 years, we’ve learned a lot more about the effects of high cholesterol, and we’ve discovered that although the average American’s LDL runs around 130 mg/dL, the optimal LDL level is 100 mg/dL or less. For someone with cardiovascular disease, diabetes, or at high risk for heart disease, the goal has been lowered to 70 mg/dL. This means that many more people are now treated with statins than in years past.
Controvery Over Widespread Statin Use
At the same time that the use of statins has soared, controversy regarding over-prescribing of the drugs has also emerged. It’s true that not everyone needs a statin, and some doctors have been overzealous in recommending them. In addition, some people will develop muscle aches and other side effects of the drugs. Dangerous side effects are uncommon and generally reversible; deaths related to statin use are very rare. Despite the downsides, for those at high risk for heart disease and stroke, statins can truly be life savers.
Recent Statin Research
A recent report from the Heart Protection Study Group, published in the medical journal The Lancet, evaluated over 20,000 individuals at risk for heart disease who had been treated with either simvastatin or a placebo pill for 11 years. On average, LDL cholesterol dropped by about 40 mg/dL compared to baseline. For this relatively modest fall in cholesterol, heart attacks and death from cardiovascular disease declined by 23 percent. Over the same period of time, total deaths were lower by about 14 percent for the statin users. There was no increased risk for cancer of any type, nor was there an increase in deaths from kidney or liver disease.
If you need statin therapy, this latest news should reassure you of the safety and effectiveness of the drugs. Of course, not everyone needs or will benefit from a statin. If you have heart disease or diabetes, your doctor will probably recommend a statin. If not, there are several useful tools to help you and your doctor decide how aggressive to be. To figure out your 10 year risk for cardiovascular disease, you can calculate your Framingham score, based on your age, gender, blood pressure, cholesterol, and smoking status. A coronary calcium score can also be helpful in identifying heart disease in its earliest stages. Statistics and tests can help determine who is at highest risk, but for optimal health and vitality, there is no pill that will ever take the place of a healthy way of life.
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