by Dr. Iain Corness
The business of cholesterol reduction
Cholesterol reduction is big business.
Should it be?
Well, before answering that question, you must look at whether the results
of cholesterol reduction are positive. There are those who say that the side
effects outweigh the benefits, but more who say the benefits are such that
everyone should be on Statins, the cholesterol reducing pharmaceutical.
But first a little history. I was never one to be the first to prescribe new
‘wonder’ drugs, but with the cardiologists sending patients back on this
drug regimen, I too began to prescribe it. Simvastatin became one of the
drugs I enjoyed prescribing most - it actually did work! Not that other
prescribed medications did not work, but Simvastatin produced an amazing
lowering of the body’s burden of cholesterol very quickly. And every time.
However, the long term results of any drug use are sometimes difficult to
demonstrate at first. After many years, does your blood pressure go through
the roof? Or do your dangly bits fall off? In some instances it could be a
case of ‘wait and see’. However, as far as is possible, the results of
longer term usage are looked at through many ways, including animal testing.
The poor old laboratory mouse is flat out keeping numbers up to scratch!
There is just so much information to collect - there are epidemiological
results found from over hundreds of thousands of cases and critically
reviewing the results at the end. This is one of the ways that
differentiates between the pharmaceutical industry and the “alternative”
Now, a startling fact has emerged from one of the longer term examinations
of statin usage. It appears that statins safely reduce the risk of
cardiovascular illness even years after treatment is stopped, according to a
probe into the popular cholesterol-lowering group of drugs published a
couple of years ago.
A look at the background is justified here. Statins work by blocking a liver
enzyme that makes fatty molecules, which line arterial walls and increase
the danger of heart disease and strokes. With worldwide annual sales of more
than 20 billion dollars, the lingering questions persisted about their
long-term safety for the heart, liver and cancer risk.
In one examination, researchers at the Heart Protection Study Collaborative
Group in Oxford in the UK looked at 20,536 patients at risk of
cardiovascular disease who were randomly allocated 40 mg daily of
Simvastatin or a dummy look-alike (known as placebos) over more than five
In this study, those who took the statins saw a reduction in “bad”
cholesterol (LDL) and a 23 percent reduction in episodes of vascular
ill-health, compared to the placebo group. The exhaustive study did not end
there. The monitoring of the volunteers continued for a further six years
after the trial ended. The investigators found that the benefits persisted
throughout this monitoring period even among those volunteers who had
stopped taking the statins. Now that is somewhat amazing. In addition, there
was no emergence of any new health hazard among those who had taken, or were
continuing to take, the drugs.
“The persistence of benefit we observed among participants originally
allocated simvastatin during the subsequent six year post-trial period is
remarkable,” said one of the investigators, Richard Bulbulia.
As far as cancer incidence was concerned, a number of cancers (nearly 3500)
developed amongst the 20,536 volunteers during this follow-up period
(roughly one in six), but there was no difference in cancer incidence
between the statin and placebo groups.
Richard Bulbulia continued, saying “In addition, the reliable evidence of
safety, with no excess risk of cancer or other major illnesses during over
11 years follow-up, is very reassuring for doctors who prescribe statins and
the increasingly large numbers of patients who take them to reduce their
risk of vascular disease. In November 2010 another trial found that
long-term use of statins was less risky than thought for people with
non-alcoholic fatty liver disease (NAFLD), a common liver ailment.
So what does all this mean as far as cardiovascular disease is concerned? I
believe it is beyond doubt, that LDL cholesterol is a major factor in
coronary artery disease. It has been shown that statins do reduce LDL, do
reduce your risk, and appear safe.
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