The Heart Pill Debate -- Research Summary

BACKGROUND: Cholesterol is a waxy substance that is found in the lipids of our blood. The body needs cholesterol to build healthy cells, however high amounts of bad cholesterol, low-density lipoprotein, LDL, can increase risk for heart disease. With high LDL cholesterol, fatty deposits may develop in the blood vessels. Eventually, these deposits can make it difficult for blood to flow through the arteries. This causes the heart to not get as much oxygen-rich blood as it needs, which increases the risk of a heart attack. Decreased blood flow to the brain can cause stroke. On the other hand, having high amounts of good cholesterol, high-density lipoprotein, HDL, is good because they act as cholesterol scavengers, picking up excess cholesterol in the blood and taking it to the liver where it is broken down. The higher the HDL, the lower the LDL. High cholesterol can be inherited, but is often preventable and treatable. (http://www.mayoclinic.com/)

RISK FACTORS: There are certain risk factors that can increase a person's chance for heart disease if they already have high cholesterol. Smoking cigarettes damages the walls of blood vessels, making them more likely to accumulate fatty deposits. It can also lower levels of good cholesterol. Obesity, a BMI higher than 30, can put a person at a higher risk for high cholesterol. A poor diet, such as eating foods that are high in cholesterol, such as red meat and full-fat dairy products; eating saturated fats found in animal products; and trans fats found in some commercially baked cookies and crackers. High blood pressure, lack of exercise and a family history of heart disease are also risk factors. (http://www.mayoclinic.com/)

TREATMENT: Statins are prescribed to patients with high cholesterol because it blocks a substance that the liver needs to produce cholesterol, causing the liver to remove cholesterol from the blood. Bile-acid-binding resins are used to prompt the liver to produce more bile acid with the cholesterol, an already naturally occurring process. (http://www.mayoclinic.com/)
The Jupiter Study tested a new treatment to give patients with normal cholesterol the drug Rosuvastatin, a medication typically given to patients with high cholesterol. The drug is meant to prevent patients with normal cholesterol levels from getting high cholesterol levels. (http://www.nejm.com/ ; http://www.ncbi.nlm.nih.gov/)

APPLICATION: The study was randomized, double-blind, placebo-controlled and a multicenter trial. The study included 17,802 men and women. For the trial, men of 50 years of age or older and women 60 years of age or older, with no history of cardiovascular disease, and a low level of LDL cholesterol were eligible. Eligible subjects were randomly assigned to receive either 20 mg of rosuvastatin, or a matching placebo. At the 12-month visit, the rosuvastatin group, as compared with the placebo group had a 50 percent lower LDL cholesterol level. The results of the study showed that rosuvastatin reduced the risk of major cardiovascular events. However, it was reported that a small but significant increase in physician-reported diabetes with rosuvastatin did occur; this has also been reported in previous trials of pravastatin, simvastatin, and atorvastatin. (http://www.nejm/) MORE
The Heart Pill Debate -- Research Summary | Medical News and Health Information

FOR MORE INFORMATION, PLEASE CONTACT:
Steven E. Nissen MD FACC
Department of Cardiovascular Medicine
Cleveland Clinic nissens@ccf.org.
Beatrice Alexandra Golomb, MD, PhDbgolomb@ucsd.edu
statinstudy@ucsd.edu
(858) 558-4950 x206

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