WHAT IT ALL MEANS
“We’re back to knowing that the
more aggressive you are in punch-
ing down cholesterol, the more lives
you save,” says Weber, a cardiologist
at the SUNY Downstate Medical
Center in Brooklyn. Statins are the
drug of choice to do that punching
down. Not only do they lower LDL
cholesterol, they consistently
reduce the risk of having a heart
attack, suffering a stroke, or dying.
Then why did Vytorin, which
did lower LDL, not provide results?
“We’re learning that this is far more
than just an LDL cholesterol story,”
says Dr. Eric Topol, a cardiologist at
the Scripps Translational Science
Institute in La Jolla, California. “It’s
also about inflammation of the
arteries.” And Vytorin didn’t lower
While it’s true that elevated LDL
The next stens
helps create unhealthy arteries,
heart attacks generally only happen
when fatty plaques in the arteries
break open, causing a clot to form at
the breakage site as the artery tries
to repair itself. Drugs to reduce
arterial inflammation could prevent
such cracking and therefore help
those people who need it the most.
For example, one Crestor trial
studied people who had low LDL
but high levels of a substance called
C-reactive protein, which is the
best-known indicator of inflamed
arteries. Those people had fewer
heart attacks after taking statins.
The result of all this is that heart
doctors now believe statins could
help as many as 40 million
Americans, far more than the 10
million or so who presently take the
drugs for prevention or treatment.
If you’ve been on vytorin or Zetia alone, don’t
panic, says Cynthia Jackevicius, associate
professor of pharmacy practice at Western
University o f Health Sciences in Pomona,
California. ‘T h ey weren’t shown to cause
harm,” she says. “ But now we know that
treating or preventing heart disease isn’t a
you should lower your
cholesterol, but how you lower it.” Here’s what
to go over with your doctor:
■ Generally, stick with statins
especially true if you already have signs of heart
disease— high LDL, angina, or a previous heart
attack. You’ll likely benefit most from statins.
■ Question your Vytorin prescription
Jackevicius’s research found that as Vytorin
use increased, the tendency to take statins
decreased. “ You’re replacing a drug known to
prevent heart attacks and death with one that
doesn’t,” she says. That doesn’t make sense.
■ Check your CRP
High levels o f C-reactive
protein may indicate high heart attack risk and
suggest the need for medication.
■ Ask about statins even if your LDL
levels are OK
The Crestor research shows
you may benefit, especially if you have a family
history of heart disease or other risk factors.
BETTER HOM ES AND GARDENS SEP I EMBER
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