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 treat Crestor for some bodies with customary cholesterol levels, cardiologist Dr Steven E Nissen cheered the decision. "You have to go with the ordered evidence," said Nissen, who is chairman of cardiovascular drug at the Cleveland Clinic sildenafil. "A clinical trial was done and there was a substantial reduction in morbidity and mortality in man treated with this drug".

But Dr Mark A Hlatky, a professor of salubrity research and policy and medicine at Stanford University, has expressed doubts about the FDA move. He worries that more common people will rely on a pill 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 enlargement. "I haven't seen anything that changes my intellect about that," Hlatky said.

So, will millions of in good health Americans soon join the millions of less-than-healthy population who already take these blockbuster drugs? The FDA's Feb 9 rubber stamp of expanded use of rosuvastatin (Crestor) was based on results of the JUPITER study, which involved more than 18000 men and women and was financed by the drug's maker, AstraZeneca. People in the trial who took the drug for an average of 1,9 years had a 44 percent crop risk of heart attack, stroke and other cardiovascular problems compared to those who took a placebo - results so unresolved that the trial was cut short. Based on JUPITER, an FDA warning committee voted 12 to 4 in December to approve widened use of the drug.

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

For that specific group, Crestor makes sense, Nissen said. "Over a five-year time of time, you prevent one death or minor stroke for every 25 people treated," he noted. Whether or not others with general cholesterol should take Crestor or another statin remains unclear. "Not one and all with normal cholesterol should be treated," Nissen said. "You should give it to people with a spacy enough risk".

And he added that the results applied only to Crestor. Other popular statins include Lipitor, Pravachol and Zocor, as well as some generic versions. Those statins might not offer the same benefits, Nissen said. "Statins conflict from each other in terms of potency," Nissen said. Crestor, which is available only in a more expensive brand-name form, is toward the pre-eminent 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 need a lot of cholesterol reduction, I use the most persuasive drug," Nissen said. "If I can get a patient there with a generic drug, of course I use a generic drug". But Hlatky has his doubts about the advisability of widening statins' reach. He said he's chary to have multitude at cardiovascular risk pop a pill rather than change the lifestyle factors that put them in skirmish in the first place.

"My view has always been that you start with the basics and do the simple things anything else before you go to drugs," Hlatky said. "Lots of people are not doing the sensible things. They're not eating the exact diet, they're not exercising, they're still smoking. Most of the people in the JUPITER trial were smack in the bull's-eye of that group".

So Hlatkyays he might still prescribe a statin for someone in that group, "but I would have an intelligent conversation about the long-term risks and benefits and what you need 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 moving in the wrong direction".

He's also worried about exposing more people to the in a class by itself but still possible side effects that come with statins. The drugs can cause myalgia - severe muscle trial - and a recent study published in the British journal The Lancet found a 9 percent grow in diabetes incidence among people taking statins.

But Nissen believes the benefits of expanded use of Crestor surpass possible risks. The study that found an increased number of diabetes did not find that it was accompanied by any increase in cardiovascular problems and deaths, he noted penis big karne ki medicine in urdu. "The is one standard where the FDA got it exactly right," Nissen said.