Misleading claims and the proven facts on Cholesterols and Statins (from the ESC)

Some of the misleading claims, and the proven facts:

CLAIM: Cholesterol is not bad for us. It is a fundamental fat needed to make our cells. We can’t live without it.

FACT: Cholesterol per se is indeed essential for life. But LDL cholesterol in the blood produces fatty deposits called atherosclerotic plaques. These plaques restrict blood flow which can damage organs or lead to a heart attack or stroke. Nearly 3 million deaths worldwide are linked each year to high levels of LDL cholesterol.

CLAIM: Eating foods high in cholesterol (e.g. eggs or butter) does not kill you. Therefore, cholesterol is not a problem but a myth of the pharmaceutical industry designed to sell us drugs.
FACT: Eating eggs or butter in reasonable amounts does not increase cholesterol in the blood. An estimated 85 percent of cholesterol circulating in the body is produced by the liver, independent of what we eat, and that is where the focus should be. As for claims that the pharmaceutical industry is getting rich from selling statins, the vast majority of these drugs are no longer covered by patents. They are generics sold for cents.

CLAIM: There is no link between a population’s LDL-cholesterol levels and the frequency of heart attacks.

FACT: Globally, about 33% of coronary heart disease cases can be attributed to high cholesterol. More than half of Europeans (54%) have high LDL cholesterol. For adults between the ages of 35 and 55, even if they are otherwise healthy, every decade that they live with high cholesterol increases their chances of developing heart disease by 39%. Germany has one of the highest cholesterol levels in the world and is ranked second amongst high income countries in the rate of deaths caused by ischemic heart disease.

CLAIM: High LDL cholesterol is less dangerous than many other factors, including inactivity, smoking and obesity. Changing those things in our lives is where we need to act first. FACT: “All those factors are contributors to the risk of heart disease,” said Professor Stephan Gielen, past president of the European Association of Preventive Cardiology. “It is indeed critical to stop smoking, be physically active and watch one’s diet. But lifestyle changes typically reduce cholesterol levels by only 5 to 10 percent. For people with high levels of LDL cholesterol, more is needed,” he said. “Combining exercise and statin therapy substantially reduces the mortality risk and is potentially the ideal combination.”

CLAIM: The side effects of statins are not worth the risk.

FACT: The most common side effect reported by statin users is muscle aches (myalgia), which occurs in less than 1 percent of patients and are often alleviated by switching to another brand of statin. Claims of more severe side effects, including Type 2 diabetes, Alzheimer’s, and cancer have been occasionally reported, but the evidence is weak or misinterpreted. Statins can indeed raise blood sugars slightly. But one would have to have significant pre-diabetes to develop Type 2 diabetes because of a statin. This occurs in only about 1 percent of patients with pre-diabetes taking the medication.

On Alzheimer’s disease, a study recently published in the Journal of the American College of Cardiology found no association between statin use and a decline in memory or thinking ability. Indeed, patients who take statins for heart disease and have a genetic predisposition to Alzheimer’s disease actually scored better on some memory tests. The lead author of the study, Doctor Katherine Samaras, a professor of medicine at the University of New South Wales, Australia said, “If you are experiencing memory problems while taking statins, don’t stop. Talk to your doctor. You may have other factors for that memory loss.”

CLAIM: Those taking statins should simply stop taking them.

FACT: Published studies have shown that patients who are taking statins and at risk for cardiovascular disease, increase that risk if they stop taking the medicine. One alarming study of 28,000 patients found that 3 in 10 stopped taking their statins because they presumed the aches and pains they were experiencing were due to the drug. The result: 8.5% suffered a heart attack or stroke within just four years, compared to 7.6% who continued taking the drugs. And there is good evidence that the benefits of statin use continue well into old age.

CONCLUSION:

There is absolutely no question that the benefits of statins far outweigh any risk,”  “You owe it to yourself to see for yourself – to review the many published, peer-reviewed studies, from reputable institutions. The stakes are simply too high to do otherwise.”

 

https://www.escardio.org/Education/Practice-Tools/Talking-to-patients/arming-your-patients-with-the-facts-on-statins?twitter&fbclid=IwAR1CYhMPZKs2uGlf20N7MzycSZr88G_cUrQap4l8zh6STeaC1gEtsD3ln5U

 

 

New Cholesterol Guidelines Abandon LDL Targets!

 

The American College of Cardiology (ACC) and American Heart Association (AHA), in conjunction with the National Heart, Lung, and Blood Institute (NHLBI), have developed and released Guidelines for Cholesterol Control after 9 years of the release of the last version. 

And they contain some substantial changes!

Gone are the recommended LDL- and non-HDL–cholesterol targets, specifically those that ask physicians to treat patients with cardiovascular disease to less than 100 mg/dL or the optional goal of less than 70 mg/dL.

According to the expert panel, there is simply no evidence from clinical trials to support treatment to a specific target. As a result, the new guidelines make no recommendations for specific LDL-cholesterol or non-HDL targets for the primary and secondary prevention of atherosclerotic cardiovascular disease.

Instead, the new guidelines identify four groups of  patients in whom physicians should focus their efforts to reduce cardiovascular disease events. And in these four patient groups, the new guidelines make recommendations regarding the appropriate “intensity” of statin therapy in order to achieve relative reductions in LDL cholesterol.

 

The Four Major Statin Groups

The four major patient groups who should be treated with statins were identified on the basis of randomized, controlled clinical trials showing that the benefit of treatment outweighed the risk of adverse events. The four treatment groups include:

1. Individuals with clinical atherosclerotic cardiovascular disease.

2. Individuals with LDL-cholesterol levels >190 mg/dL, such as those with familial hypercholesterolemia.

3. Individuals with diabetes aged 40 to 75 years old with LDL-cholesterol levels between 70 and 189 mg/dL and without evidence of atherosclerotic cardiovascular disease.

4. Individuals without evidence of cardiovascular disease or diabetes but who have LDL-cholesterol levels between 70 and 189 mg/dL and a 10-year risk of atherosclerotic cardiovascular disease >7.5%.

 

In those with atherosclerotic cardiovascular disease, high-intensity statin therapy—such as rosuvastatin (Crestor, AstraZeneca) 20 to 40 mg or atorvastatin 80 mg—should be used to achieve at least a 50% reduction in LDL cholesterol unless otherwise contraindicated or when statin-associated adverse events are present. In other settings a  moderate reduction of LDL-cholesterol may be aimed for.

The guidelines advise not to aim to achieve a target value of LDL-cholesterol in these patients subsets but advice to start statins in moderate or high intensity to achieve significant reductions in LDL cholesterol from their baseline levels.

 

via New Cholesterol Guidelines Abandon LDL Targets.

What should be your Ideal Cholesterol?

What are the types of Fats in our body?

The human body contains different types of fats or lipids. Lipids are important chemicals present in the body and needed for various cellular functions. The fats in our body are of different types. They can simply be divided in Bad and Good fats.

Which are the Bad fats/ lipids? How do they harm us?

The Bad fats get deposited in our arteries thereby causing blocks. These blocks decrease the blood supply of the organs causing various serious illnesses like heart attacks (decrease blood supply to the brain), paralytic strokes (decrease blood supply to the brain), or gangrene of the limbs (decrease blood supply to the limbs). Thus it is important to keep our Bad cholesterol below the normal range.  There are 2 types of Bad Cholesterol in our body: LDL Cholesterol and Triglycerides. Higher levels of Bad Cholesterol can be harmful in the long run.

Which are the Good fats/ lipids? Do they harm us?

The Good Cholesterol is protective and higher levels are better. The Good Cholesterol in our body is HDL Cholesterol.

How do we know our fat/lipid level?

One needs to do a Complete lipid profile (blood test) after 12 hours of fasting.

What should be your LDL (Bad) Cholesterol level?

If one suffers from any of the below mentioned illnesses, then the LDL Cholesterol needs to be below 100 mg/dl. These disorders are

  1. Diabetes
  2. Heart attacks 
  3. Blocks in your coronary artery causing angina (chest pain)
  4. Undergone angioplasty or bypass surgery
  5. Renal failure
  6. Blocks in any of your arteries: carotid artery or peripheral arteries
  7. Dilatation of your aorta.

 

Does diet and exercise help to reduce Bad Cholesterol?

Yes, they do. Brisk walking every day for 30-45 minutes can help reduce your bad cholesterol and increase your good cholesterol. Avoiding foods rich in fats like fried food, cakes, sweets can also help reduce the bad cholesterol.

 

Are there medicines which reduce Bad Cholesterol and prevent heart attacks?

Statins are called the wonder drugs which reduce LDL cholesterol. These drugs are extremely safe and also decrease triglyceride levels and increase the good cholesterol! They have been proven to prevent heart attacks and in some cases reduce the blocks! These drugs need to be taken on a daily basis and need to be continued lifelong.

Cholesterol, fats, lipids! what are they and what should be their levels?

What are the types of Fats in our body?

The human body contains different types of fats or lipids. Lipids are important chemicals present in the body and needed for various cellular functions. The fats in our body are of different types. They can simply be divided in Bad and Good fats.

Which are the Bad fats/ lipids? How do they harm us?

The Bad fats get deposited in our arteries thereby causing blocks. These blocks decrease the blood supply of the organs causing various serious illnesses like heart attacks (decrease blood supply to the brain), paralytic strokes (decrease blood supply to the brain), or gangrene of the limbs (decrease blood supply to the limbs). Thus it is important to keep our Bad cholesterol below the normal range.  There are 2 types of Bad Cholesterol in our body: LDL Cholesterol and Triglycerides. Higher levels of Bad Cholesterol can be harmful in the long run.

Which are the Good fats/ lipids? Do they harm us?

The Good Cholesterol is protective and higher levels are better. The Good Cholesterol in our body is HDL Cholesterol.

How do we know our fat/lipid level?

One needs to do a Complete lipid profile (blood test) after 12 hours of fasting.

What should be your LDL (Bad) Cholesterol level?

If one suffers from any of the below mentioned illnesses, then the LDL Cholesterol needs to be below 100 mg/dl. These disorders are

  1. Diabetes
  2. Heart attacks
  3. Blocks in your coronary artery causing angina (chest pain)
  4. Undergone angioplasty or bypass surgery
  5. Renal failure
  6. Blocks in any of your arteries: carotid artery or peripheral arteries
  7. dilatation of your aorta.

Does diet and exercise help to reduce Bad Cholesterol?

Yes, they do. Brisk walking every day for 30-45 minutes can help reduce your bad cholesterol and increase your good cholesterol. Avoiding foods rich in fats like fried food, cakes, sweets can also help reduce the bad cholesterol.

Are there medicines which reduce Bad Cholesterol and prevent heart attacks?

Statins are called the wonder drugs which reduce LDL cholesterol. These drugs are extremely safe and also decrease triglyceride levels and increase the good cholesterol! They have been proven to prevent heart attacks and in some cases reduce the blocks! These drugs need to be taken on a daily basis and need to be continued lifelong.