Cholesterol Targets Should Be Set Far Lower, Study Finds | NYT

[Ediacara]

Cholesterol Targets Should Be Set Far Lower, Study Finds
By GINA KOLATA

Published: March 8, 2004

Lowering cholesterol far below the level that most doctors now consider adequate can substantially reduce patients' risk of having or dying from a heart attack, researchers reported today.

The findings, cardiologists say, will greatly change how doctors treat patients with heart disease and will provide the impetus to re-evaluate how low cholesterol levels should be.

The study compared high doses of one of the most powerful cholesterol-lowering drugs, Pfizer's Lipitor, to a less potent drug, Pravachol, made by Bristol-Myers Squibb, which conducted the trial.

The patients taking Lipitor were significantly less likely to have heart attacks or to require bypass surgery or angioplasty, the study found. Both drugs are statins, a class of medications that block a cholesterol-synthesizing enzyme and are often prescribed for patients with heart problems.

More at the New York Times

[izzie]

1. Do not tell me this, I eat nothing of interest now.

What next?????

[w4rma]

4. Eat what you want. Buy, use Lipitor! You are getting sleepy.

Why does this article in the NYT seem like a Lipitor infomercial to me?

[WannaJumpMyScooter]

21. It is not just an article in the NYT, it was the official findings of

the American College of Cardiology today.

[w4rma]

23. True. True.

After reading the article I was going to recommend Lipitor, but then I read deseo's post #13. I'll need to research that.

[Malva Zebrina]

2. I am not sure who to believe anymore

really

[amazona]

3. any lower...

...and everyone over 40 will be required to take Lipitor. I am a thin, fit woman who exercises a minimum of 30 minutes a day and sometimes an hour. But I am a middle-aged woman. My cholesterol is over 200. And I eat a healthy diet! As these medicines are much too expensive for me, there seems little I can do other than ignore the constant negativity. I know other thin people who have taken the cholesterol lowering drugs, their cholesterol was lowered, and they had had a heart attack/bypass anyway.

I'm suspecting a scam but like you just don't know where to turn for the truth.

[kutastha]

5. over 200

Is that your LDL or total? Do you have hypertension? Do you have a family history of hypertension or cardiac problems? Are you diabetic? Do you smoke? Are you under a lot of stress?

These are just some examples how a good history can make a difference. If there's no signs of trouble, a patient can have a high cholesterol value and be just fine. But an article like this is something to keep in mind when choosing a drug for those who may not be fine and are having trouble keeping their numbers in check.

[amazona]

8. I do have a good history

The total was 214, and the "good cholesterol" was 85 of it, so the doctor said not to worry about it. Don't smoke, not a diabetic, used to have low/normal blood pressure, now have normal blood pressure (on the low side for someone my age, though, I think -- 90/70). Stress is subjective but I certainly wouldn't consider myself stressed.

It's just hard to know what to think, if I am being told not to worry because it's a real "not to worry," or it's an HMO not wanting to kick in for a very expensive medicine. I'm having a hard time keeping my insurance and I do know there's a rebound with cholesterol lowering drugs if you have to quit them so don't want to start something and not be able to finish.

[kutastha]

10. oh dear

I didn't mean for you to give all that info out! I was just using all that as an example. :) A good number to look at is the ratio of total to HDL (good) cholesterol. You're at 2.5 which is well-below the suggested cutoff of 5.

But it's something to consider. Just keep an eye on all your vitals and keep taking care of yourself. Good luck.

[amazona]

14. thanks!

I appreciate it. I didn't know what the ratio was supposed to be. It sounds like I shouldn't be too concerned for the time being. I'm a big garlic and olive oil user so maybe that helps with the good cholesterol.

[Malva Zebrina]

6. I cannoot tell you where to go

at all.

there is much information on the net.

we must at one point, decide if we are being duped by the pharma companies.

I refuse to take the statins and opted for the alternatives.

I exercise when the weather allows, twenty four minutes three times a week and I am not a young person.

and I am sick of this.

I am a diabetic--and when I want to make an appointment with the "doctor" the vaunted "doctor" I must call on the day I want that appointment.

So, I did that. Well guess what. there were no appointment available on that day and on the subsequent days that I called. So I could not have an appointment to see "my doctor"

What the fuck is that?

I tell you people--enjoy your life as it is. take every advantage and if you die a few years ahead of what they tell you they can keep you alive, then go for the entire Epicurean delight.

[scarletlib]

7. Try Cinnamon

We have a doctor who does a daily 5 minute health program here in west palm beach. last week he cited a study that indicated that 1/2 teaspoon of cinnamon added to your daily diet could be as effective as the statin drugs in lowering cholesterol levels. he suggested putting the cinnamon into your coffee grounds just before adding the water to make the coffee.

i am trying it. i figure it can't hurt and it might just help.

[Malva Zebrina]

9. Yeah right

and a whole lot of people need to take statins, therefore LOL

I am extremely suspicious of these types of things.

Extremely.

there are a whole lot of things that are recommended I have researched them all. Do not get fat is the only one that makes any sense. We get fat here, because we eat too much---period. There are few excuses no matter how much people may claim they have some sort of a deficit in their metabolism.

I am very sorry if I have offended any persons who are fat. If you eat too much, you will get fat. And if you get fat, you will be at risk for all sort of diseases. And do not think that the pharma companies do not have you in their scopes. They will hold it against you at one point for your fatness, believe me. I think it is comeing. while all the while you are held hostage to the pharma and the food industry who keeps trying to envelope you into eating more!

The fact is that fat persons are at risk for all sorts of illness and early death. That is the fact.
There is NO excuse for this as far as you the arbitor of your own health is concerned. You have been duped by corporate schills who tell you that it is healthy to feed your children cereal that is full of sugar.

my recommendation is that you enjoy your life as a slim person and adopt an Epicurean philosophy.

If you are fat you need to stop eating so much.

and you need to not teach your children that being fat is an acceptable health alternative.

[amazona]

11. ok thanks

I just tried it with some decaf and, er, well, it takes some getting used to. But I guess it beats bypass surgery. Maybe I can try 1/4 ts. twice a day instead?

[Ediacara]

15. Put the cinamon

In the basket with the coffee grounds, but just use a dash. If you put it up there the taste is more delicate, plus you don't get the atrocious sediments in the bottom of your cup :-)

[PaDUer]

16. I'm a thin woman also..

and middle aged, my cholesterol was over 400..am on Lipitor for years..However, I had a stroke in '94 and have autoimmune illnesses..am on MANY meds.

[dflprincess]

19. Ask your doctor about a C Reactive Protien test

It measures inflamation and there's more and more evidence that it might be as valuable as a cholestoral test (Johns Hopkins says premiliniary evidence is that it might be more valuable for women than cholestoral). Inflamation may explain why people who don't have blood pressure or cholestoral problems still have heart attacks.

My doctor ordered it for me because of age, family history and my cholestoral was right at 200 (though the ratio was good). However, my insurance company wouldn't pay for it - says it's unproven - it cost about $70.

[ithacan]

12. drug company profits...

I really have a hard time seeing this as anything but a way to boost drug company profits.

I think these drugs are appropriate only for people who have seriously high levels due to genetic factors.

All the other prescriptions for this (and these drugs are VERY expensive) are just padding the profit margins of the drug companies and are one of the causes of the skyrocketing cost of health care...

[sendero]

13. Maybe..

... but then again maybe not.

My wife has used statin drugs for years. A few months back, she started getting recuring muscle cramps. She thought it might be potassium or another electrolyte, and made the necessary dietary and supplement adjustements.

The cramps got worse. She tried this, and she tried that, and finally in desparation got on the web and did some serious research.

It seems that these statin drugs have a well-known side effect in some people - muscle degeneration. Now, the studies never show this because they are relatitively short. But many have died when the heart muscle has become so compromised it fails.

Her doctors were skeptical, and had her try lower doses, other statin drugs, etc - but the results were quite consistent. As soon as she started taking them the cramps returned.

Now surely, the side effects of any drug have to be weighed against the drug's benefits. I'm not saying the statin drugs are bad. But I can't help but wonder that if the high doses they are proposing are used, if many more people will experience this side effect.

She has decided to eschew the statin drugs and will use another strategy to lower her cholesterol. A promising one used a kind of fiber to absorb the cholesterol as it is dumped from the liver into the digestive tract. Not very high tech, but no risk either, and apparently somewhat effective.

[varun]

17. I used Fish Oil

...for three months, and my total cholesterol came down from 182 to 156, and my triglycerides came down from 390 to 136! My LDL and HDL showed improvement too.

I also improved my diet and am less stressed now due to lifestyle changes...so maybe Fish Oil is not the only reason for the good results.

[twilight]

20. how about Omega 3?

I've been taking 1,000 mg. of Omega 3 which also has the equivalent of 1 entire bulb of garlic in it - supposed to lower cholesterol. I hope it does lower my cholesterol because it is quite high and it has been for many years.

The doctors want me to go on those drugs of course, but right now I'm trying the dietary approach with the Omega 3 added. Those statin drugs have plenty of side-effects and they cost a bundle besides.

:dem: :kick:

[Snellius]

18. Well there goes another $1000 a year

The only trick that makes Lipitor affordable -- for those of us who don't have drug coverage -- is that you can split the tablets. (The chemists at Pfizer will tell you, if the tablet is not scored, you can't split the pill, but you can.) Pfizer prices it according to dose not dosage, so that 20, 40, or 80 mg dosages are all roughly the same price, about $100 for 30. With a razor a blade and a few minutes it's easy to save about $50 dollars a month. Unfortunately, now it sounds like they're going to try to pump as much Lipitor through your system at it will hold.

[sendero]

22. Yes....

.... good old "unit pricing".

If the megadoses of this stuff catch on, wanna bet they do away with "unit pricing" or raise prices across the board?

If, 20 years ago, someone would have told me that pharmaceutical companies would become among the most rapacious and unethical in all of America, I would never have believed you. Believe it.