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Cardiologists debate over heart drugs

December 27, 2011 2:49:36 PM PST
A landmark study has changed how some cardiologists view a popular drug used to lower bad cholesterol. Some are now prescribing it to patients with normal cholesterol, but some doctors think it might do more harm than good.

Portia Tibbs is taking steps to help control her cholesterol. She is also taking cholesterol lowering statins just like millions of other people.

"I don't really like taking medicine, but I have to," Portia Tibbs said.

Now because of the so-called Jupiter study many doctors are urging some people with normal cholesterol to start taking them too. Jupiter tested more than 15,000 people who had normal LDL levels and high levels of an inflammation biomarker.

"For the group taking statins there was between a 40 and 50 % reduction in the risk of the things we really care about, like death, stroke, heart attack," Steven E. Nissen, MD, Fellow of the American College of Cardiology and Chairman of the Department of Cardiovascular Medicine at Cleveland Clinic, explained.

After less than two years the five year study was cut short because of those findings. Cleveland clinic cardiologist Steven Nissen says the study changed the way he practices medicine. He tells us before the results, he and a lot of other doctors occasionally did blood tests for inflammation.

"Well, we're making that measurement more often now," Dr. Nissen said.

Doctors may use the results to prescribe statins to prevent heart disease. But, University of California - San Diego, Dr. Beatrice Golomb says it is not known with longer term use and in real world users, whether the benefits outweigh the real risks.

"It's portrayed as being so fantastically safe it should be put in the water supply. The real world use this drug causes problems not infrequently," Beatrice Alexandra Golomb, M.D., Ph.D., an, associate professor of medicine at the University of California - San Diego School of Medicine, said.

Golomb tells us while some people benefit from statins others have reported symptoms similar to Alzheimer's. Muscle weakness, nerve damage, and cognitive problems have also been issues.

For people in the Jupiter study...

"There was evidence of a significant increase in incident diabetes," Dr.Golomb said.

She wants to see more studies on the drug's long term effects on patients with inflammation, but Dr. Nissen still believes in most of those cases statins work.

"It's taken more to convince others and I respect people who are cautious," Dr.Nissen said.

Dr. Golomb says she would like to see other, potentially safer, anti-inflammatory agents like low-dose aspirin tested to see if the effects are similar or even better than statins. As for people with normal cholesterol, other risk factors for heart disease inflammation blood tests are inexpensive and available at just about every hospital.

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