Many people at risk for cardiovascular disease (CVD) don’t have their elevated cholesterol and other lipid disorders under control.Studies have shown that proper treatment of cholesterol disorders can reduce the risk of developing heart disease.Even cholesterol disorders are common among people without CVD.
Researchers found that about a fifth of high-risk persons who did not qualify for lipid-lowering treatments had substantial coronary artery calcium (CAC), and the number of people who qualified for drug treatment but weren’t treated differed according to presence and severity of CAC.Given the significance of CVD as a public health problem in the United States, and the proven benefits of lipid-lowering drugs, improving the treatment and control of cholesterol disorders and eliminating disparities in management should move to the forefront of national public health efforts.
Worldwide thousands of people taking cholesterol-lowering statin drugs are suffering unnecessary heart attacks because they are not complying with the recommended treatment, Dutch researchers said recently.
The researchers estimate up to 9,000 European and 7,000 American statin users have heart attacks that are avoidable.
The statins (or HMG-CoA reductase inhibitors) form a class of hypolipidemic agents, used as pharmaceuticals to lower cholesterol levels in people with or at risk for cardiovascular disease. The first results can be seen after one week of use and the effect is maximal after four to six weeks.Statins lower cholesterol by inhibiting an enzyme that controls how much is produced in the body. Pfizer's Lipitor, Merck's Zocor and AstraZeneca's Crestor are among the leading statin drugs on the market.LDL-lowering potency varies between agents. Cerivastatin (Lipobay, Baycol) is the most potent, followed by (in order of decreasing potency) :
*Rosuvastatin (Crestor) ,
*Atorvastatin (Lipitor / Torvast) ,
*Simvastatin (Zocor/ Lipex) ,
*Lovastatin (Mevacor / Altocor),
*Pitavastatin (Livalo / Pitava) , and
*Fluvastatin (Lescol).
Heart patients who received intensive cholesterol-lowering therapy in the four months after a heart attack or other coronary event had about half as many strokes as those who were not given the drugs.
It is clear that that lowering cholesterol immediately after a heart attack appears to reduce the risk for later stroke.
"Getting users to stay on statins and to use them persistently saves lives, and doctors must get over to patients the message that complying with treatment is essential," Dr Fernie Penning-van Beest, of the PHARMO Institute in Utrecht, said in a statement.
High cholesterol, along with smoking, diabetes, high blood pressure and being overweight, is a risk factor for heart disease, one of the biggest killers in Western countries.
The drugs are effective if taken properly, but some people may be taking doses that are too low or have stopped treatment.
The Dutch study of nearly 60,000 new statin users and their prescriptions in the Netherlands over a two-year period found that about half the patients stopped taking the drugs during that time. Roughly a third were on a high or intermediate dose.
Hospital admissions for heart attacks dropped by 30 percent in statin users compared to patients not complying with the treatment, the study found. They believe that the impact of using the drugs properly would be similar in Europe and the United States.
In the study published in the European Heart Journal they calculated that every year up to 400 statin users in the Netherlands have a heart attack that could have been avoided.
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