-CLEVELAND, Ohio (Ivanhoe Newswire) — Heart disease is the leading cause of death in the US. More than a quarter of Americans over the age of 40 are taking a statin to lower their cholesterol and to lower their risk of heart attack and stroke. In fact, statins are one of the most prescribed drugs in the country. But what happens if you are statin-intolerant? It turns out, there’s other help for your heart.
Steven E. Nissen, MD, Chief Academic Officer of the Heart Vascular & Thoracic Institute at Cleveland Clinic says, “Statins are marvelous drugs. They have probably saved as many lives as any drugs we’ve ever developed.”
If someone has high levels of LDL cholesterol, known as “the bad” cholesterol, it can build up in the walls of blood vessels and create blockages. Statins are the first line of defense to lower those levels. But Doctor Nissen says that up to 15 percent of the people who need statins experience debilitating muscle pain when they take them. statin-intolerant
Doctor Nissen explains, “At some point, they will come to us and they will say, ‘I just can’t take these drugs. I don’t feel well enough when I take them.’”
Alternatives include ezetimibe, but it’s only effective in some people. PCSK9 inhibitors are powerful but need to be injected every couple of weeks. Now a Cleveland Clinic – led clinical trial found that the use of bempedoic acid reduced adverse cardiovascular outcomes in 14 thousand statin-intolerant people.
“For some of these people who just desperately need to have their LDL cholesterol treated, yes, it can be really an important drug.” Explains Doctor Nissen.
After six months, bempedoic acid reduced LDL cholesterol by 23 percent and reduced inflammation by 22 percent. There was also a 30 percent reduction in major cardiovascular events and a 39 percent decline in heart attacks.
Doctor Nissen says, “It’s another reason why we believe that you ought to treat early, and you ought to treat intensively.”
Doctor Nissen says side effects from bempedoic include a slightly higher risk for gout and gallstones.
Contributors to this news report include: Marsha Lewis, Producer; Roque Correa, Editor and Kirk Manson, Videographer.
Sources:
PLAN B FOR STATIN-INTOLERANT PATIENTS
REPORT #3138
BACKGROUND: Heart disease refers to several types of heart conditions. The most common in the United States is coronary artery disease (CAD), which affects the blood flow to the heart. Decreased blood flow can cause a heart attack. Sometimes heart disease is considered silent and not diagnosed until a person experiences signs or symptoms of a heart attack, heart failure, or an arrhythmia. A heart attack can include chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort; dizziness; and shortness of breath. Signs of arrhythmia are fluttering feelings in the chest, or palpitations. Heart failure presents shortness of breath; fatigue; or swelling of the feet, ankles, legs, abdomen, or neck veins. Key risk factors for heart disease are high blood pressure, high blood cholesterol, and smoking. About 47 percent of people in the United States have at least one of these three risk factors.
(Source: https://www.cdc.gov/heartdisease/about.htm)
STATINS – RISK VS BENEFIT: More than one in four Americans over the age of 40 take statins, or cholesterol-lowering drugs. By helping to reduce blockage in blood vessels, statins reduce the chances of cardiovascular disease and strokes. “Studies continue to point to statins for preventing heart attacks as well as strokes. There’s rarely a situation where someone who’s at-risk shouldn’t consider them,” says Dr. Douglas S. Jacoby, Medical Director at the Penn Medicine Center for Preventative Cardiology and Lipid Management. Statins do have a risk of side effects that include muscle pain, liver damage, increased blood sugar, and fuzzy thinking. However, these side effects can be eliminated through trial and error and are 100 percent reversible. statin-intolerant
NEW STUDY ON STATINS IMPROVING BLOOD VESSEL HEALTH: Stanford Medicine researchers and collaborators have uncovered how statins protect the cells that line blood vessels. Using new genetic tools to study statins in human cells and mice, the findings provide new insight into statins’ wide-ranging benefits, for conditions ranging from arteriosclerosis to diabetes. “The study gives us an understanding, at a very deep mechanistic level, of why statins have such a positive effect outside of reducing LDL,” said professor of medicine Joseph Wu, MD, PhD. Researchers tested a common statin, simvastatin, on lab-grown human endothelial cells derived from induced pluripotent stem cells. Endothelial cells make up the lining of blood vessels, but in many diseases, they transform into a different cell type, known as mesenchymal cells, which are poor substitutes. They suspected that statins could reduce this harmful transition. When the cells were treated with simvastatin in a dish, they formed more capillary-like tubes, a sign of their enhanced ability to grow into new blood vessels. They found that after eight weeks on simvastatin, the diabetic mice had significantly improved vascular function, with arteries that more easily relaxed and contracted. These findings could help doctors identify and treat early signs of vascular damage.
(Source: https://med.stanford.edu/news/all-news/2023/05/statins-cardiovascular-vessels.html)
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