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Cardiovascular disease (CVD) remains the in the USA. Statins, a clbad of cholesterol-lowering drugs, are one of the most effective preventative measures to reduce the risk of cardiovascular disease.
It is well established that statins save lives, but a recent study shows that even after two years, half of the prescribed people on prescription do not achieve healthy cholesterol levels.
Researchers are now exploring the possibility of creating personalized treatments to help people better achieve their cholesterol goals.
High cholesterol is one of the most widely recognized contributors to CVD. In the United States, approximately adults have high levels of LDL, the most harmful type.
Statins reduce cholesterol by blocking a substance necessary for its manufacture. They can even help your body to relieve the cholesterol accumulated on the walls of the arteries, preventing blockages and reducing the risk of CVD.
Dr. Nieca Goldberg, Cardiologist and Medical Director of the Joan H. Tisch Center for Women's Health at NYU Langone Medical Center, told Healthline, "Statins are very effective at lowering LDL levels and reducing the risk of cardiovascular disease. . "
She added, "What people do not realize is that only about 15% of high LDL is due to poor nutrition or lack of exercise. Much of it is genetically determined, so statins may be the best way to reduce levels. "
United States and United Kingdom guidelines to prevent deaths from cardiovascular disease set treatment goals. The National Institute for Health and Wellness in the United Kingdom (NICE) is planning a 40% (or more) reduction in LDL.
Researchers based in the UK have investigated the extent to which patients respond to statin therapy, in line with the NICE recommendation, and how this affects their risk of cardiovascular disease.
The researchers included 165,411 patients who had not been treated for CVD before starting statin therapy.
They found that almost half did not respond well enough after two years of statin therapy. There was also a higher rate of heart disease in those who had not reached the LDL target levels.
Dr. Ralph Akyea, author of the study and research badociate at the University of Nottingham, told Healthline: "We found that for every drop of one millimole of LDL cholesterol, the risk MCV was 6% lower among those who did not reach the 40% goal. , compared to a 13% decrease in CVD risk for those who reached the target. "
"The most surprising is the magnitude of the statins prescribed to individuals for the primary prevention of CVD not reaching the recommended reduction. These people do not derive optimal benefits from statins to prevent heart disease and stroke, "said Akyea.
"This boosts the health benefits of statins and the achievement of the goal."
The results indicate that genetics and drug discontinuation may explain these findings.
Goldberg said: "Membership in general is a problem; Studies show that six months after the start of treatment, only half of patients take a particular medication. But with statins, people are often scared by the negative attention of the media about them.
More individualized care can be the solution.
She thinks: "Doctors can fix it. If the reasons why statins are needed and their effectiveness in lowering cholesterol are clearly explained, there is a better chance that patients will stick to it. "
Dr. Victoria Shin, a cardiologist at Torrance Memorial Medical Center, told Healthline, "All medications must be personalized. Each patient comes with a particular set of concomitant problems, sensitivities and risk factors that can be determined by genetics, the environment as well as lifestyle habits. It's not "one size fits all". "
A recent survey of nearly 6,000 people with patients found that almost 20% of them did not receive statin treatment, although they are eligible under the guidelines of the American College of Cardiology (ACC) and the American Heart Association (AHA).
Of these patients, 60% said they did not receive the drug and others said they feared for their side effects, which is why they refused or discontinued their use.
"Updating doctors' current guidelines could improve this situation, but another problem is the length of doctor visits to basic care – there may not be enough time. I think we need to do a better job by hiring the doctors to have this discussion with patients, "said Goldberg.
"I am always surprised that patients are more likely to believe online blogs about the dangers of statins and to ignore the scientific literature on benefits. Physicians need to take the time to educate our patients and examine how this affects this particular patient.
Most people tolerate statins very well, but there may be side effects.
According to Goldberg, muscle pain is common and it is important to tell your doctor if you feel this way. "We perform a blood test called CPK that measures muscle breakdown. If this indicates a problem, we can recommend stopping statins for a week or two or reducing the dose. Often, we can find a good balance by simply adjusting the dose. "
"It can also produce enzymes in a liver function test, which we test with a blood test. In addition, all statins are likely to cause some mental confusion, "said Goldberg.
But Goldberg pointed out: "The benefits outweigh the risks."
We can also take steps to keep our cholesterol levels in a healthy range.
Goldberg said that exercise can help. "Exercise particularly aerobic; walk, run, swim, choose an exercise you like and do it.
As far as the diet is concerned, "it's about reducing saturated fats, meat fats and dairy products. You can instead use one percent dairy products and, without eliminating the meat, you must reduce the amount in small portions. The Mediterranean diet is what I recommend to my patients because it contains healthy fats. "
Statins save lives, but one study found that half of people who use statins do not achieve healthy cholesterol after two years of treatment. The problem is that people do not take statins as prescribed and doctors do not do enough to educate their patients about the drug.
Individualized care that requires more time with patients and information about the benefits of statins may be helpful. Health care providers should also be aware of prescribing guidelines.
Although lifestyle and diet changes can reduce levels, statins remain the most effective way to reduce unhealthy LDL cholesterol levels.
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