Controversial Cholesterol Drugs
Preventing Heart Disease With A Pill
Current cholesterol guidelines are being questioned by doctors and researchers amidst drug recalls and severe side effects of pharmaceutical treatments.
Current guidelines for cholesterol levels place almost 40 million Americans into the at-risk group that would benefit from pharmaceutical intervention. The American Heart Association (AHA) recommends that “therapeutic life changes” be attempted before drug consideration. The life changes include exercise, weight loss, and diet change. If the blood levels of LDL cholesterol still exceed 190 mg/dL in persons with no history of heart disease or 130 mg/dL in patients with coronary heart disease then the AHA recommends prescription intervention.
However, many doctors and researchers are questioning these guidelines since the benefits of the cholesterol-lowering drugs called statins seem to be limited to men who have had previous heart disease or who are at risk due to family occurrences of the disease. Also, statins have not been shown to have clear benefits in women. Other types of cholesterol drugs are also in question since there are reports of severe side effects and death, counter productive to preventing premature death from heart disease.
Patient Deaths and Prescription Drug Recalls
The first recall of cholesterol-lowering drugs was of Bayer Pharmaceutical’s Baycol in 2001. It was linked to muscle wasting that lead to 31 deaths in the United States and at least nine abroad. At the time of the recall the drug was prescribed to an estimated 700,000 Americans. Patients were told to not worry about the other five statins on the market at the time. As quoted by CBS News, “Baycol has been linked to significantly more fatal cases than its competitors” according to Dr. John Jenkins of the FDA. His suggestion was that patients who suffer muscle pain should speak to their physician about a lower dose or a different medication. There was speculation that complications arose when Baycol was taken with another prescription drug, gemfibrozil, which lowers triglyceride levels. But that had been the situation in only 12 of the cases.
It is common practice to prescribe multiple drugs to accomplish the single task of lowering LDL levels by inhibiting multiple parts of the cholesterol machinery. In fact, the AHA recommends multi-drug therapy if a patient’s cholesterol levels are not decreasing as expected on single drug therapy, though the additional drugs have not been approved by the FDA for lowering LDL levels.
Unfinished Clinical Trials of Cholesterol Drugs
Cholesterol has been presented as being of two types: good cholesterol, clinically known as HDL, and bad cholesterol, clinically known as LDL. In November 2006 the Wall Street Journal reported that Pfizer’s HDL-increasing drug torcetrapib increased patients’ blood pressure during clinical trials. This is problematic since high blood pressure is a risk factor for heart disease, the condition the drug is supposed to help prevent. The company’s response was that when taken in conjunction with their LDL lowering drug Lipitor, torcetrapib is beneficial. A month later Pfizer halted clinical trials, an $800 million loss for the pharmaceutical company according to Forbes, due to increases in patient deaths when taking torcetrapib in combination with the drug atorvastatin, also known as Lipitor.
The Solution to Handling High Cholesterol
Patients with heart disease, or those at high risk due to lifestyle or family cases, who have high cholesterol could benefit from prescription medications. Attempt lifestyle changes and consult a physician for appropriate advice. Follow medication directions precisely and do not ignore side effects. Consult a physician for suggested evaluations and when necessary for altered doses or medications.
