Issue Date: September 9, 2007
Statins, cholesterol, heart patients and cancer risks
Cholesterol-lowering drug's benefits outweigh possible risks, our expert reports.
One of my heart patients recently asked me if it's possible for her cholesterol level to get too low.
She was concerned after hearing about a recent study that suggested heart patients with lower cholesterol levels might be at a higher risk for developing cancer. The study -- conducted by researchers at Tufts-New England Medical Center and published in the "Journal of the American College of Cardiology" -- found that for every 100 patients treated with statin drugs to lower their cholesterol, among those with the lowest cholesterol levels there was one more case of cancer than among those with higher levels.
Studies like this are important because they make doctors think through the potential risks vs. benefits of various therapies that we prescribe. But before everyone flushes their cholesterol medicine down the toilet, let's review the study in a little greater detail.
The researchers conducted what is called a meta-analysis. This means that they didn't directly study the patients themselves; instead, they reviewed data from many different studies they pooled together (23, in this case). One strength of a meta-analysis is that it increases the number of patients studied, but a weakness is that the data comes from many, sometimes varied, sources. As a result, the research itself should be kept in perspective.
Interpreting studies such as this one can be confusing for the average person. We all want to do what's right, and just when we think we've got a handle on things, information like this gives cause for pause.
To help get a better idea of the risk, I spoke with Scott Grundy, one of the nation's leading authorities on the subject. He is the director of the Center for Human Nutrition at the University of Texas Southwestern Medical School in Dallas. He has spent his entire medical career studying the effects of cholesterol and cholesterol treatments.
I asked Grundy for his thoughts on low cholesterol levels as they pertain to health. Here's what he had to say: "To date, there is no significant evidence that lowering cholesterol from high to low with either diet or medicine causes cancer. Even if there were to be some side effects, the benefit for preventing heart disease in high-risk patients far outweighs any adverse effect. Because of this, people being treated for high cholesterol should be assured that the known benefits far outweigh any theoretical adverse side effects."
This is good advice. Although it's important not to ignore findings from new research showing potential risks from treatments, it's also important to sift through the information to see if other factors might explain the findings. For example, in this study, it's possible that the increased cancer incidence came about because treatment with the statin drugs enabled the patients to live longer.
As with any medicine, people taking statins to lower their cholesterol need to follow up with their doctor to be sure their treatment program is right for them. As for my heart patient, we discussed the risks and benefits of her medicine, and, when she left my office, she took her new prescription with her.
Tedd Mitchell, M.D., president and medical director of Dallas' Cooper Clinic, writes HealthSmart every week.
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Diabetic? Cholesterol drugs may prevent foot damage
50% of diabetics have a serious disorder that can lead to amputation.
If you're diabetic and your feet or hands sting, tingle or lack sensation, the cause may be nerve damage, called peripheral sensory diabetic neuropathy.
About half of all diabetics have it, says the American Diabetes Association. The serious condition can lead to ulcers, infections and even amputations.
The good news: Research finds that two types of lipid-lowering drugs -- statins and fibrates, both used to prevent cardiovascular disease -- can reduce your risk of developing neuropathy. And if you already have nerve damage, these medicines may slow its progress, says lead researcher Timothy Davis, M.D., Ph.D., professor of medicine at the University of Western Australia.
Other diabetic tips from the researcher:
See your doctor. All diabetics should be checked at least annually for foot problems. If you have symptoms, let your doctor know right away. Early treatment can help avoid problems.
Check feet frequently, especially if you suspect problems or your circumstances change (i.e., new pair of shoes). Look for sores, cuts and skin breaks. Use a mirror if necessary.
Take care of your feet. Use lotion (but not between toes), wear well-fitting socks and shoes, wash with warm water, and dry off thoroughly. Get therapeutic shoes if needed. Medicare may cover them if you have foot problems.
Work out wisely. Some exercises strain the feet; stick with activities like cycling, swimming or rowing. -- Susan T. Lennon
Christopher Thomas, Getty
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