Should healthy people with no heart symptoms take a cholesterol-lowering drug (CLD) to prevent heart disease? Federal regulators in the U.S. have recently given the green light to allow Crestor, one of the CLDs, to be sold for this purpose. So is this decision a scientific breakthrough or medical madness?
Why should millions of healthy people be added to the millions already prescribed CLDs? The reason is a study of 17,800 people who had no heart disease, but did have high amounts of c-reactive protein (CRP) in the blood, which is linked to an inflammatory process in arteries.
Half of coronary deaths occur in people who are apparently healthy. So why not use CLDs to decrease bad cholesterol and CRPs as much as possible? This is what some doctors advise in both the U.S. and Canada. But there are a few "ifs" to consider.
A Harvard professor once made a remark that all doctors should consider. He said, "it’s impossible to make a patient feel any better who doesn’t have any complaints!" So far, no study has shown CLDs help people live longer or better if they have no heart disease.
How safe is it to use Crestor, or other CLDs to decrease the cholesterol level? Some cardiologists believe the lower, the better, But cholesterol is a major component of cell membranes, needed in several metabolic processes, and there’s a high concentration of cholesterol in the brain. When CLDs lower the production of cholesterol in the liver, they also lower the amount in the brain. Some researchers believe this adversely affects brain function.
For example, Duane Graveline, a physician astronaut, developed transient global amnesia after being on Lipitor 10 mg. Graveline did not recognize his wife or children and couldn’t believe he had been an astronaut and doctor. His NASA physicians refused to believe Lipitor could have this effect. Six months after his recovery, doctors again prescribed just 5 mg. of Lipitor. This resulted in another episode of amnesia.
Since then, Dr. Graveline has documented hundreds of cases showing CLDs pose an increased risk of neurological and musclular complications. Other studies show an increase in violent crimes and car accidents by those prescribed CLDs, which may be related to change in brain function.
Some researchers believe, and I share this view, that prescribing CLDs to those with normal hearts is risky. But there is little doubt this will continue. Millions of dollars are spent by pharmaceutical companies to determine further benefits of CLDs. But there are no millions available to study negative aspects of the treatment.
It’s time to lose weight, stoop smoking, eat a well-balanced diet and take the advice of former U.S. President Abraham Lincoln who remarked, "We have the best two doctors in our body, our left and right legs."
Winnipeg Free Press (Your Health)
Friday, August 6, 2010
W. Gifford - Jones MD
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