Statins: other approaches do as well

statins:-other-approaches-do-as-well

Statins are among the most prescribed drugs in the world. When it comes to lowering bad cholesterol or LDL (sometimes also called LDL-C for low-density lipoprotein cholesterol), statins are in most cases the treatment of choice and have been shown to be effective. However, some patients cannot stand these drugs, in particular because of side effects in the muscles.

Scientists have sought to know if other drugs or treatments such as a specific diet could have the same effectiveness as statins in lowering LDL and reducing cardiovascular risk. The answer is yes, these treatments (excluding statins) are able to provide the same level of protection for heart health. We know that a high LDL level very significantly increases the risk of suffering from cardiovascular diseases such as myocardial infarction or stroke.

Numerous studies have shown a reduced risk cardiovascular disease with statins, but there was a lack of conclusive studies with treatments considered to be more marginal. In addition, treatment recommendations (guidelines) often speak of statins but forget the final objective, that is to say a lowering of the level of LDL in the blood. A bit as if we were no longer interested in a path to follow rather than the final destination.

Review of 49 clinical studies

To reach these conclusions, a team from Brigham and Women’s Hospital attached to Harvard University in Boston who conducted this study analyzed or reviewed 39 previously published clinical studies totaling more than 300 ‘000 people. Of these studies, 25 looked at statins and the rest looked at a special diet for a healthy heart rich in particular in dietary fiber, taking ezetimibe which is a molecule that blocks the absorption of cholesterol in the digestive tract, drugs acting on the bile, gastric bypass surgery which has the effect of promoting the transformation of cholesterol into acid bile and newer cholesterol medications called PCSK9 inhibitors.

The lower the LDL level, the greater the risk of a cardiovascular event.

The authors found that the association between reduced LDL levels and the risk of suffering from serious cardiovascular events such as death , stroke or heart attack were similar between the different therapies. Each 1 mmol / L reduction (or 30 mg / dL) in LDL was associated with a relative decrease in 23% at 25% of the risk of suffering from serious cardiovascular events. The treatments had a different impact on lowering cholesterol levels. Ezetimibe leads to a decrease in LDL of 20%, statins of 30 at 50% depending on dosage and PCSK9 inhibitors of approximately 50%.

But The important thing to remember is that each unit of LDL decreased in the bloodstream reduces cardiovascular risk, regardless of the method or treatment used by the doctor. For example, if a special diet allows you to lose 1 mmol / L of LDL and a statin leads to the same decrease, the end result is the same. According to the American scientist, the results show that several methods can achieve this goal. There is a rather linear relationship between the decrease in LDL and the decrease in cardiovascular risk. The lower the LDL level, the lower the risk of a cardiovascular event.

Very effective alternatives to satines

This work research also shows that non-drug methods such as diet, supplemented by regular exercise, are very valuable therapies for reducing cardiovascular risk. To take an image, the main thing is really the destination (having an LDL rate in the standard) and not the way to get there.

Source

http://jama.jamanetwork.com/article.aspx?articleid= 2556125

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