Use Of Cholesterol Drugs By Patients Without High Cholesterol Level

Use Of Cholesterol Drugs By Patients Without High Cholesterol Level.
When the US Food and Drug Administration in February 2010 approved the use of the cholesterol-lowering statin numb Crestor for some grass roots with natural cholesterol levels, cardiologist Dr Steven E Nissen cheered the decision. "You have to go with the orderly evidence," said Nissen, who is chairman of cardiovascular pharmaceutical at the Cleveland Clinic rxlist box. "A clinical ass was done and there was a strong reduction in morbidity and mortality in kith and kin treated with this drug".

But Dr Mark A Hlatky, a professor of condition exploration and policy and medicine at Stanford University, has expressed doubts about the FDA move. He worries that more mortals will rely on a medication rather than diet and exercise to cut their heart risk, and also points to studies linking statins such as Crestor to muscle troubles and even diabetes. "I haven't seen anything that changes my attention about that," Hlatky said.

So, will millions of hale Americans soon conterminous the millions of less-than-healthy race who already take these blockbuster drugs? The FDA's Feb 9 green light of expanded use of rosuvastatin (Crestor) was based on results of the JUPITER study, which knotty more than 18000 ladies and gentlemen and was financed by the drug's maker, AstraZeneca. People in the trial who took the stimulant for an average of 1,9 years had a 44 percent put down risk of heart attack, stroke and other cardiovascular problems compared to those who took a placebo - results so extraordinary that the test was cut short. Based on JUPITER, an FDA advisory council voted 12 to 4 in December to approve widened use of the drug.

The persons in the trial included men over 50 and women over 60 with regular or near-normal cholesterol levels. However, these individuals did have high-class levels of C-reactive protein, a marker of infection that has also been linked to cardiovascular problems. They also had at least one other heart endanger factor, such as obesity or high blood pressure.

For that specific group, Crestor makes sense, Nissen said. "Over a five-year time of time, you proscribe one death or minor thump for every 25 people treated," he noted. Whether or not others with customary cholesterol should take Crestor or another statin remains unclear. "Not everybody under the sun with normal cholesterol should be treated," Nissen said. "You should give it to nation with a high enough risk".

And he added that the results applied only to Crestor. Other everyday statins include Lipitor, Pravachol and Zocor, as well as some generic versions. Those statins might not fabricate the same benefits, Nissen said. "Statins argue from each other in terms of potency," Nissen said. Crestor, which is present only in a more expensive brand-name form, is toward the surmount of the list in terms of potency, he noted, while generic drugs such as simvastatin (Zocor) and pravastatin (Pravachol) have much less effective effects.

"For patients who privation a lot of cholesterol reduction, I use the most mighty drug," Nissen said. "If I can get a patient there with a generic drug, of run I use a generic drug". But Hlatky has his doubts about the advisability of widening statins' reach. He said he's disinclined to have consumers at cardiovascular risk burst a pill rather than change the lifestyle factors that put them in trouble in the first place.

"My dream has always been that you start with the basics and do the simple things maiden before you go to drugs," Hlatky said. "Lots of people are not doing the sensible things. They're not eating the aptly diet, they're not exercising, they're still smoking. Most of the woman in the street in the JUPITER trial were smack in the centre of that group".

So Hlatky says he might still prescribe a statin for someone in that group, "but I would have an versed conversation about the long-term risks and benefits and what you trouble to do to reduce the risks. It is so much easier to command a drug than to change behavior, and that is my worry," Hlatky said. "We're heading down that road. Cardiovascular jeopardy prevention is inspirational in the wrong direction".

He's also worried about exposing more people to the outstanding but still possible side effects that come with statins. The drugs can cause myalgia - violent muscle pain - and a recent read published in the British journal The Lancet found a 9 percent better in diabetes incidence among people irresistible statins.

But Nissen believes the benefits of expanded use of Crestor compensate possible risks. The study that found an increased occurrence of diabetes did not find that it was accompanied by any increase in cardiovascular problems and deaths, he noted stores that sell vigrx pills. "The is one prototype where the FDA got it exactly right," Nissen said.