Statin Alternative to Lower Cholesterol


CLEVELAND, Ohio (Ivanhoe Newswire) – According to the CDC, about two in every five Americans struggle with high cholesterol. If left untreated, it could lead to heart disease or stroke. Statins are usually the gold standard for treating high cholesterol, but about 15 percent of patients have statin intolerance. Now a team of researchers at the Cleveland Clinic are leading a trial looking into an alternative to statins. Statin Alternative

Stroke and heart disease are two leading causes of death in the U.S. Both conditions could be a result from a common American health issue – high cholesterol. Statins play a pivotal role in lowering LDL levels, or “bad cholesterol”, in the body. But about 10 to 15 percent of the population don’t tolerate statins.

Cardiologist and Chief Academic Officer of Cleveland Clinic’s Heart, Vascular, & Thoracic Institute, Dr. Steven Nissen is evaluating a statin alternative in a trial called CLEAR Outcomes.

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“Bempedoic acid does lower cholesterol, it’s a bit less effective, but it can be combined with another drug, known as ezetimibe, and the two together can lower the bad cholesterol,” Dr. Nissen explains.

At the end of the trial, researchers found there was a 13 percent reduction of cardiovascular death, heart attack, and stroke in the patients that received the statin alternative.

Dr. Nissen says, “Those people who can’t tolerate statins are good candidates to be treated with bempedoic acid.”

There are a few risks associated with the alternative, including a one percent increase in the risk of gout and an increased risk of gallstones.

Contributors to this news report include: Adahlia Thomas, Associate Producer; Cleveland Clinic, Videographer; Roque Correa, Editor.

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Dr. Steven Nissen




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BACKGROUND: LDL, which stands for low-density lipoprotein, is considered “bad cholesterol” because high amounts of it can result in plaque buildup and cause cardiac events. About 86 million Americans age 20 or above have high levels of LDL and about 7 percent of children in the U.S. between the ages of 6 and 19 have high cholesterol. The normal LDL level for adults should be below 100 mg/dL. LDL levels can be affected by diet, body weight, smoking, age, or gender. Having high blood cholesterol raises the risk for heart disease, which is the leading cause of death, and for stroke, the fifth leading cause of death in the U.S.


SYMPTOMS & DIAGNOSING: High cholesterol is a silent illness because you don’t show symptoms until it causes other problems in your body, like cardiac events such as heart attacks or stroke. The only way to diagnose high levels of LDL is through a blood test called a lipid panel, which tells you how many lipids are circulating in your blood. People should get their cholesterol checked every five years starting at age nine until the age of 45 for males and 55 for females, where it should be checked every two years. After age 65, cholesterol should be checked every year. If you are under 45 and have a family history of high cholesterol or risk factors, you should get your cholesterol checked more often than every five years. A few ways to lower high cholesterol are with statins, a healthy diet, avoiding tobacco use, exercising, and lowering stress.


NEW TECHNOLOGY: Statins are usually prescribed to patients to lower their cholesterol levels, but some people have an intolerance to the medication. A Cleveland Clinic cardiologist is leading a study in an alternative to statins. The CLEAR Outcomes Trial uses bempedoic acid to lower statin intolerant patients’ cholesterol levels, as well as their risks of experiencing heart attacks or strokes. “They support this drug as an effective therapy for the 7 to 29 percent of patients who report statin intolerance, which can be a vexing clinical challenge,” says the study’s first author, Steven Nissen, MD, Chief Academic Officer of Cleveland Clinic’s Heart, Vascular & Thoracic Institute. Dr. Nissen says, when taken in its combination formulation with ezetimibe, bempedoic acid can reduce LDL-C by 35 to 40 percent. “That’s about the same reduction as with a moderate-intensity statin. Patients can get a statin-like effect on their LDL cholesterol without taking a statin.”



Shannon Kelley

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Doctor Q and A

Read the entire Doctor Q&A for Dr. Steven Nissen, cardiologist and Chief Academic Officer

Read the entire Q&A