The new guidelines on cholesterol treatment advocate aggressive control of Cholesterol levels by drugs called statins for primary prevention of heart disease. They advocate high-intensity and moderate intensity statins in patients with intermediate risks of developing heart disease.
Majority of the Physicians would be following these recommendations. But, there is a great need to discuss the risks and benefits of statin therapy with individual patients.
These become more relevant when we know that statins do increase marginally the incidence of developing diabetes.
Two recent studies also throw up interesting findings:
Study 1. A study presented in April 2014 at the Society of General Internal Medicine meeting in San Diego showed that individuals prescribed statin therapy for high cholesterol consumed more calories and more fat than nonstatin users. And, not surprisingly, this increase in calories paralleled an increase in BMI in statin users.
Study 2. An analysis of a prospective cohort study of men (published in JAMA Internal Medicine) revealed that physical-activity levels were “modestly” lower among statin users compared with nonusers independent of other cardiac medications and of medical history.
Though there may be a biologic or chemical explanation for the above findings, the above studies point to Lifestyle-Statin interaction whereby there seems to be a sense of protection felt by the patients on statins. Individuals on statins (due to a sense of security due to their drug compliance) may be abandoning on Diet moderation and Physical activity. This abandoning of important lifestyle measures would reduce gains of statin therapy.
The above findings suggest that Physicians need to continuously emphasise the importance of Lifestyle measures to individual patients irrespective of their cholesterol levels or statin therapy!