Tuesday, October 09, 2007

New statin news

I find patients are reluctant to begin statins because they fear these drugs (Lipitor, Zocor, pravastatin and others) will harm their livers. In fact, statins have a strong safety record with respect to liver problems.

Two new reports suggest some interesting non-cardiovascular benefits associated with statin use. German researchers(1) compared a group of colorectal cancer (CRC) patients to a cancer-free group with respect to their use of low-dose aspirin, statins, or both. Regular use of low-dose aspirin reduced risk of CRC by 23% whereas statin use diminished risk by 35%. Use of both therapeutic strategies, as would be commonly seen in patients at high risk for cardiac disease, dropped cancer risk 37%, and use for more than 5 years of the double treatment plunged risk by 62%.

Both smokers and ex-smokers also benefited from statin use with respect to progression of cigarette-related lung disease. Old Oklahoma vets demonstrated a slower decline in lung function and fewer urgent visits for respiratory issues if on statins. The study authors(2) speculated that the anti-inflammatory effects of statins were responsible for the favorable effects on lung function.
(1)Int J Cancer 2007;121:1325-1330.
(2) Chest Published online October 1, 2007.


S said...

aspirin, statins and probably ACEI are the wonder drug of the century probably. They save so much lives and still they are under-used in countless situations. This is especially so for aspirin. If all the guidelines can be followed we can prevent / reduce so many disease / teir complications. More than reluctance of patients, i will say it is reluctance of the doctors that lead to under-use. smalltowndoc.

Jean said...

When patients come in and are reluctant to use a drug, is it because they take more interest? Years ago, I doubt patients would ever question or even read about concerns.

Femail doc said...

Small town doc: Have you heard of the polypill? British researchers proposed that all the best of preventive medicine be rolled into one mega-capsule that could potentially decrease risk of heart disease by one-third when taken by all persons at risk, a population defined by them as anyone over the age of 55.

The polypill proposal calls for six ingredients blended together to reduce four different risk factors rated as top causative culprits for heart attack and stroke. Blood pressure, lipid levels, homocysteine concentration, and platelet function would be controlled by three antihypertensives (a thiazide diuretic, a beta-blocker, and an angiotensin converting enzyme inhibitor), a statin (generic Zocor), aspirin, and folic acid.

Apparently Dr Reddy's Laboratories, of Hyderabad, India is currently conducting trials of a modified version of this polypill. The Indian version contains aspirin, lisinopril, simvastatin, and atenolol, and a trial is underway on a group of 250 patients who have already had a cardiovascular event.

Jean: Patients are often quite interested in their health. Some come in armed with very good info from the Internet, and more than once have helped me think of a good diagnostic possibility or therapeutic option. Some come in armed with alarm from media reports or info from a friend of a friend. Either way at least gives me a starting point.

Years ago, we also used to dress up to go to the doctor!

S said...

Yes. The polypill concept got more coveraf\ge after the article published in British medical journal. As you know there are controversies on it, including not much of additive benefits, giving unnecceary drugs to many people...I feell, giving every patient above 55 will make us convert more healthy people into patients.-smalltowndoc.wordpress.com

Dr. Smak said...

(in my best homer simpson voice):
Statins. Is there nothing they can't do?

Aspirin as the wonder drug is so yesterday.

Strokes, MIs, colon CA, alzheimer's. When they publish research showing that statins improve postmenopausal libido they'll have it in the bag.

Mauigirl said...

Very interesting. Glad to hear the liver problems are rare. A friend of ours is taking a statin and his cholesterol is way down now - and a good thing, too, because heart disease runs in his family. Good news, thanks for sharing.