HeartScore: Statins
As we continue our "Heart Score" series, we turn our attention to medications used to combat heart disease, the number 1 killer in the United States. Dr. Emily Senay is here to discuss why too few of those who need cholesterol-lowering medications are getting them.
The drugs we are talking about are called statins. Right now there are six on the market, and you may be more familiar with the brand names--Mevacor, Pravachol, Zocor, Lescol, Baycol, and Lipitor.
They are all statins: cholesterol-lowering medications that in study after study have been shown to be extremely beneficial in lowering the bad kind of cholesterol known as LDL cholesterol. Several of these drugs have been shown to prevent heart disease and even the progression of heart disease: That is already established. They also help prevent stroke and diabetes.
The fact of the matter is that by some estimates, 20 million people who could benefit from the drugs are not getting them: Only about one in five who need them are actually getting them.
There are several reasons. The drugs are expensive--in some cases, $3 per pill. It can also take time for things to sink into clinical practice--into how doctors typically treat a given condition. And some doctors can be reluctant to give somebody a pill when they have high cholesterol but no outward signs of disease.
Patients themselves can be reluctant to start medication when they have no signs of disease. Some researchers want to see these drugs be sold over the counter, but the US Food and Drug Administration recently rejected this idea.
Cholesterol in the body comes from two places. We get it by eating it in foods that by now we all know have cholesterol, like eggs and meat. But our own bodies also make cholesterol, and this is where the statins work. They interrupt an enzyme necessary for manufacturing of cholesterol in the liver and therefore reduce cholesterol. There is also new evidence that these drugs also can have unexpected benefits like reducing inflammation of the arteries.
If you have heart disease, you should absolutely have already talked to your doctor about statins. If you have high cholesterol and additional risk factors for heart disease like obesity or smoking, you should talk to your doctor about them. Even people who have cholesterol levels that are essentially normal have been shown to have fewer heart attacks when they take these medications.
High cholesterol means several things. Total cholesterol should be 200 or less. But you also need to know what your bad cholesterol is--that's the LDL--and you want to shoot for below 130. You also want to know what your good cholesterol is--that's the HDL--and that should be higher than 50. You want more good and less bad, obviously. Statins can lower bad cholesterol in some cases by 60 points.
Overall, the safety of these drugs has been shown in study after study. But for some people the liver can be affected, which is why you ned to have your liver enzymes measured before taking the drug, then 6 to 12 weeks after taking them, and then again semiannually.
©MMII CBS Worldwide Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed