Tuesday, November 2, 2010

Health Care and Statins

How does your heart feel on a normal day? Are you in relatively good shape physically and mentally for someone your age, or are you prone to suffering fits of depression, anxiety, and some heart related issues? When was the last time you had a stress test or a check up for blood pressure or cholesterol counts? Have you considered using medications to help your health condition if you fall into the ranks of Americans who suffer from these maladies?  If you have high cholesterol, or at risk for heart attack, then you may be a candidate for a statin drug. Definitely, a conversation with your doctor is in order.
 
"Statins" are a class of drugs that lower the level of cholesterol in the blood by reducing the production of cholesterol by the liver. Statins block the enzyme in the liver that is responsible for making cholesterol, according to MedicineNet.com. Statins block the enzyme in the liver that is responsible for making cholesterol. This enzyme is called hydroxy-methylglutaryl-coenzyme A reductase (HMG-CoA reductase). Scientifically, statins are referred to as HMG-CoA reductase inhibitors.

Cholesterol is critical to the normal function of every cell in the body. However, it also contributes to the development of atherosclerosis, a condition in which cholesterol-containing plaques form within arteries, according to MedicineNet. These plaques block the arteries and reduce the flow of blood to the tissues that arteries supply. When plaques rupture, a blood clot forms on the plaque, thereby further blocking the artery and reducing the flow of blood. When blood flow is reduced sufficiently in the arteries that supply blood to the heart, the result is angina (chest pain) or a heart attack. If the clot occurs on plaques in the brain, the result is a stroke. If the clots occur on plaques in the leg, they cause intermittent claudication (pain in the legs while walking). By reducing the production of cholesterol, statins are able to slow the formation of new plaques and occasionally can reduce the size of plaques that already exist. In addition, through mechanisms that are not well understood, statins may also stabilize plaques and make them less prone to rupturing and promoting the development of clots. The important role of cholesterol in atherosclerosis is widely accepted by scientists. Research from the last few years shows that aggressive cholesterol reduction is more beneficial than modest reductions.

According to the FDA, There are no warning symptoms of high cholesterol. But a simple blood test by your doctor will measure the different kinds of cholesterol. Low-density lipoprotein (LDL) or "bad" cholesterol can clog the arteries. Lower numbers of LDL are best. The higher the LDL level, the greater the risk for heart disease. High-density lipoprotein (HDL) or "good" cholesterol carries bad cholesterol out of your blood, back to the liver, where it can be eliminated, to keep it from building up in the arteries. The higher the HDL level, the lower the risk for heart disease. For information on what your cholesterol numbers mean, visit www.nhlbi.nih.gov/health/public/heart/chol/wyntk.htm#numbers .

According to the FDA, the following factors affect blood cholesterol levels:

--Certain foods - eating too much saturated fat, found mostly in animal products, and too much cholesterol, found only in animal products.
--Heredity - genes play a role in influencing the levels.
--Weight - excess weight tends to increase the levels.
--Exercise - regular physical activity may not only lower LDL cholesterol, but it may increase the level of desirable HDL cholesterol.
--Smoking - cigarette smoking lowers HDL cholesterol.
--Age and gender - cholesterol levels naturally rise as men and women age. Menopause is often associated with increased LDL cholesterol in women.

Statins are drugs that are used to lower cholesterol but they might be beneficial for people with cholesterol levels within the normal range. Whether you need to be on a statin depends on your cholesterol level along with your other risk factors for cardiovascular disease, according to Cooper University Health. If you have high cholesterol, meaning your total cholesterol level is 240 mg/dL or higher, or your "bad" cholesterol (LDL) level is 130 mg/dL or higher, the numbers alone won't tell you or your doctor the whole story. Other risk factors including heredity, diet and whether you are a smoker all need to be considered. High cholesterol affects all arteries, not just those in the heart. Its negative effects permeate the body, so it's likely that the benefits of lowering cholesterol might have widespread health benefits as well. So who should take statins and what can they do for you?


According to the FDA, statins are relatively safe for most people, but some can respond differently to the drugs. Certain people may have fewer side effects with one statin drug than another. Some statins, in particular Lovastatin and Simvastatin, also are known to interact adversely with other drugs. This information, coupled with the degree of cholesterol-lowering desired, will help guide the decision about which statin to use, or whether another type of drug should be used. Statin medications (HMG-CoA reductase inhibitors)
work in the liver to prevent formation of cholesterol, are effective in lowering bad cholesterol levels and raising good cholesterol. They are not recommended for pregnant patients or those with active or chronic liver disease, and statins can cause serious muscle problems. Currently available statins are listed here:
--Lovastatin (Mevacor, Altoprev).
--Pravastatin (Pravachol).
--Simvastatin (Zocor).
--Fluvastatin (Lescol).
--Atorvastatin (Lipitor).
--Rosuvastatin (Crestor).

Although statins are well tolerated by most people, they do have side effects, some of which may go away as your body adjusts to the medication, according to the Mayo Clinic. Common, less serious side effects include the following symptoms:
--Muscle and joint aches (most common).
--Nausea.
--Diarrhea.
--Constipation.

Potentially serious side effects, according to the Mayo Clinic, include the following symptoms:
1.) Liver damage. Occasionally, statin use causes an increase in liver enzymes. If the increase is only mild, you can continue to take the drug. If the increase is severe, you may need to stop taking it, which usually reverses the problem. If left unchecked, increased liver enzymes can lead to permanent liver damage. Certain other cholesterol-lowering drugs, such as gemfibrozil (Lopid) and niacin, increase the risk of liver problems even more in people who take statins. Because liver problems may develop without symptoms, people who take statins have a blood test six weeks after starting a statin medication to check their liver function. After that, your doctor may recommend yearly blood tests.

2.) Muscle problems. Statins may cause muscle pain and tenderness (statin myopathy). The higher the dose of statin you take, the more likely you are to have muscle pains. In severe cases, muscle cells can break down (rhabdomyolysis) and release a protein called myoglobin into the bloodstream. Myoglobin can damage your kidneys. Certain drugs when taken with statins can increase the risk of rhabdomyolysis. These include gemfibrozil, erythromycin (Erythrocin), antifungal medications, nefazodone, cyclosporine and niacin. If you take statins and have new muscle aching or tenderness, check with your doctor.

It's important to consider the effects of statins on other organs in your body, especially if you have health problems such as liver or kidney disease. Also, check whether statins interact with any other prescription or over-the-counter drugs or supplements you take. Keep in mind that when you begin to take a statin, you'll most likely be on it for the rest of your life. Side effects are often minor, but if you experience them, you may want to talk to your doctor about decreasing your dose or trying a different statin. Don't stop taking a statin without talking to your doctor first.

According to the FDA, there are simple steps you can take concerning cholesterol:
--Have your blood cholesterol levels checked at least once every 5 years if you are an adult 20 years or older.

--Check with your doctor. You may be able to lower your cholesterol levels by eating better and exercising more.
--Maintain a healthy weight. Being overweight increases your risk for heart disease.
--Stay active every day.
--Use the food label to choose foods lower in saturated fat, including trans fats, and calories.
--Eat more fruits and vegetables.
--Don't stop taking any cholesterol-lowering medications you may be on without first talking to your doctor.

Statins, based upon all current research and patient results, are considered a good way to reduce the risk of heart attack. However, they are not for everyone. Plus, they are expensive. Only your doctor can help you with this diagnosis and suggested medication for your particular medical situation. Don't try any self-diagnosis, but if you have concerns about the decision to begin a regimen including statin drugs, make sure to investigate all the options before moving forward.

Until next time. Let me know what you think.

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