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How Quickly Do Statins Lower Cholesterol

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How Statins Work to Reduce Cholesterol

Though statins are incredibly effective, there are many different forms of heart disease. Heart disease is still the No. 1 killer of men and women in our country, and the epidemic is spreading throughout the world. As long as the battle continues, well continue researching new ways to prevent and treat heart disease.

How Quickly Can Cholesterol Levels Change

The Cholesterol Levels in the blood is not only affected by the daily diet, but also depends on the speed at which the body manufactures and eliminates LDL cholesterol, and heart disease is caused by the amount of LDL cholesterol in the blood. The body can make the cholesterol the body needs without having to get extra from food.

There are reasons

for high and low cholesterol. Many factors determine whether your LDL cholesterol level is high or low, including:

  • Heredity
  • pressure

Heredity

There are genetic genes in the body that control the rate at which LDL cholesterol is manufactured and eliminated, thus affecting the level of LDL cholesterol. And familial hypercholesterolemia is a special hereditary high cholesterol condition, 1 in 500 people suffer from it, leading to the occurrence of early heart disease.

Eating habits

There are two substances in food, which will increase LDL cholesterol

  • Saturated fat: A type of fat mainly derived from animals.
  • Cholesterol: It also comes from animal food.

Eating too many foods containing saturated fat and cholesterol is the main reason for high cholesterol and high heart disease rate because saturated fat can increase the level of Low cholesterol more than any other food. Therefore, reducing the consumption of saturated fat and cholesterol-rich foods is very important to reduce blood cholesterol levels.

Weight

Exercise

Regular exercise can lower LDL cholesterol levels.

Age and gender

Alcohol

Stress

Myth #: Taking Statin Drugs Leads To Diabetes Out Of The Blue

Truth: In clinical trials, statins appear to accelerate a diagnosis of adult-onset diabetes because they cause a slight elevation in blood sugar. However, people experiencing this side effect already have higher than normal blood sugar, or prediabetes, explains Martin. For those who are borderline diabetic, the mild increase in blood sugar can lead to a diabetes diagnosis about five weeks earlier than it would be otherwise.

Research indicates that statin drugs do not induce diabetes in someone who isnt already nearing a diabetes diagnosis. Additionally, the benefits of reducing cardiac events in someone who has prediabetes or is diabetic greatly outweigh the mild increase that might occur in their blood sugar, says Martin.

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Side Effects Of Statins

Many people who take statins experience no or very few side effects.

Others experience some troublesome, but usually minor, side effects, such as diarrhoea, a headache or feeling sick.

Your doctor should discuss the risks and benefits of taking statins if theyre offered to you.

The risks of any side effects also have to be balanced against the benefits of preventing serious problems.

A review of scientific studies into the effectiveness of statins found around 1 in every 50 people who take the medicine for 5 years will avoid a serious event, such as a heart attack or stroke, as a result.

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Will Statins Increase My Risk For Diabetes Or Complicate My Existing Diabetes

How Do You Lower Cholesterol

This risk is true to some extent, but its wildly exaggerated.In fact, there are good data to show that people who have problems with their blood sugar or who have diabetes benefit most from statins. Even though their blood sugar may go up slightly, the added risk is significantly offset by the reduction in heart disease risk that a statin can provide.If youre already at risk for developing Type 2 diabetes, or if you have prediabetes, you may monitor your blood glucose more closely after starting a statin. But exercise and weight loss have been shown to lower the risk of developing diabetes in those with borderline blood glucose levels, regardless of statin use.

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Effect Of Statins Therapy On Clinical Outcomes In Specific Patient Groups

PRIMARY PREVENTION

The key issue is âwhich primary prevention patients should be treatedâ and this is still controversial. It should be noted that the higher the baseline risk the greater the absolute reduction in events with statin therapy. For example, in a high-risk patient with a 20% risk of developing a vascular event, a 25% risk reduction will result in a 15% risk of an event . In contrast in a low-risk patient with a 4% risk of developing a vascular event, a 25% risk reduction will result in a 3% risk . Thus, the absolute benefit of statin therapy over the short term will depend on the risk of developing cardiovascular disease.

Additionally, based on the Cholesterol Treatment Trialists results the reduction in cardiovascular events is dependent on the absolute decrease in LDL-C levels. Thus, the effect of statin treatment will be influenced by baseline LDL levels. For example, a 50% decrease in LDL is 80mg/dl if the starting LDL is 160mg/dl and only 40mg/dl if the starting LDL is 80mg/dl. Based on studies showing that a decrease in LDL of 1 mmol/L reduces cardiovascular events by ~20% the relative benefit of statin therapy will be greater in the patient with the starting LDL of 160mg/dl than in the patient with the starting LDL of 80mg/dl . Thus, decisions on treatment need to factor in both relative risk and baseline LDL levels.

ELDERLY

WOMEN

ASIANS

How Are Doctors Sure That Statins Really Are Safe And Beneficial

Statins have been studied more than nearly any other drug that people take. In fact, more than 170,000 people who take statins have been studied in detail and for extended periods of time. We certainly know the benefits of statins.We also understand the risks of statins. In some instances, after doctors have prescribed a drug for 10 years or more, it is taken off the market because of unforeseen, adverse side effects. Weve been prescribing statins since the 1990s for patients at high risk for stroke and heart disease. With statins, the side effects actually are well known. But how can we put that in perspective?Any focus on statin side effects needs to be counterbalanced by the fact that statins reduce peoples risk of dying from heart attack, heart disease, or stroke. Data from the 2008 JUPITER Trial suggest a 54 percent heart attack risk reduction and a 48 percent stroke risk reduction in people at risk for heart disease who used statins as preventive medicine. The data are not speculative rather, they reflect statins real potential to save lives and avoid illness.There are many varieties of brand name and generic statins available. All statins work in more or less the same way to lower bad cholesterol in patients at high risk for cardiac events.Below are a few of the common brand names you may recognize, along with their generic counterparts:

  • Lipitor
  • Vytorin

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Does Lowering Your Cholesterol Protect You From Ever Having A Heart Attack

Not necessarily. Since their arrival in the 1990s in Americans medicine cabinets nationwide, statin drugs have indeed proven very effective for reducing high LDL levels, and they do slow the progression of cholesterol-filled plaques. But sadly, the #1 cause of death in Americans taking statins to lower their elevated LDL levels is still heart attacks, states Kimberly Gomer, MS, RD, LDN, one of the many faculty who teach wellness education and nutrition workshops at the Pritikin Longevity Center.

Who Can Take Statins

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You might be prescribed a statin if you have heart disease or another disease of the heart and blood vessels, or if you are at risk of developing them in the next 10 years.

If you have high cholesterol

You should be offered a statin if you have high cholesterol and lifestyle changes havent been enough to bring it under control.

Depending on your cholesterol levels and how healthy you are otherwise, you and your doctor or nurse might want you try to bring your cholesterol levels down with a healthy diet and lifestyle first, before starting statins.

If you are at risk of developing heart disease

You will probably be prescribed a statin if you are at high risk of developing heart disease or a disease of the blood vessels. For example, if you have:

  • diabetes
  • rosuvastatin .

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Who Should Take A Statin

Just because you have high cholesterol doesnt mean you should take a statin. LDL level is not the only way to decide if you need a statin. Thats because there are other risk factors for cardiovascular disease.

According to the 2018 guideline from the American College of Cardiology/American Heart Association, several groups of people should be taking a statin:

Who Should Take Them

Statins are often recommended to help prevent a first heart attack or stroke .

They are also used to reduce the risk of having a repeat heart attack or stroke in someone who has already had one .

  • Know you have heart disease or have a history of stroke, heart attack, peripheral vascular disease or chest pain, also called angina
  • Have high cholesterol or know you have Familial Hypercholesterolemia
  • Are between 40 and 75 years of age and also have diabetes
  • Are between 40 and 75 years of age and your clinician estimates how likely you are to have a heart attack or stroke or die from one in the next 10 years , and your risk is high enough to benefit from being on one

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Who Should Be Treated

In a sense, everyone. Thats because no cholesterol level is too good. But people with unhealthy levels should work hard to improve, while those with ideal results can afford to relax a bit. Table 1 shows the goals established by the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults.

Cholesterol is a crucial determinant of cardiovascular health, but its only one. In fact, smoking is even more dangerous than unhealthy cholesterol levels, and high blood pressure, diabetes, and lack of exercise are nearly as harmful. Because each risk factor adds to the harm of others, people with the most risk need the most vigorous treatment. Table 2 shows how an individuals risk profile influences the choice of therapy.

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Isolated Hypercholesterolemia In Primary Prevention

Ldlcholesterolhigh Does Oatmeal Lower Your Cholesterol? Is ...

In patients with isolated hypercholesterolemia without cardiovascular disease initial drug therapy is with a statin. The statin dose should be chosen based on the percent reduction in LDL-C required to lower the LDL-C level to below the target goal . As discussed earlier, the side effects of statin therapy increase with higher doses so one should not automatically start with high doses, but instead should choose a dose balancing the benefits and risks. Generic statins are inexpensive drugs and are very effective in both lowering LDL-C levels and reducing cardiovascular events. Additionally, they have an excellent safety profile. If the initial statin dose does not lower LCL-C sufficiently, one can then increase the dose. If the maximal statin dose does not lower LDL-C sufficiently adding ezetimibe is a reasonable next step if the LDL-C level is in a reasonable range and an additional 20-25% reduction in LDL will be sufficient. High dose statin and ezetimibe will lower LDL-C by as much as 70%, which will lower LDL-C to goal in the majority of patients who do not have a genetic basis for their elevated LDL-C levels. If the combination of statin plus ezetimibe does not lower the LDL-C to goal one can add a third drug, such as bempedoic acid or colesevelam. If the patient has diabetes with a moderately elevated A1c level using colesevelam instead of ezetimibe or in combination with ezetimibe could improve both glycemic control and further lower LDL-C levels.

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Effect Of Bile Acid Sequestrants On Lipid And Lipoprotein Levels

The major effect of bile acid sequestrants is to lower LDL-C levels in a dose dependent fashion. Depending upon the specific drug and dose the decrease in LDL-C ranges from approximately 5 to 30% . The effect of monotherapy with bile acid sequestrants on LDL-C levels observed in various studies is shown in .

How Statins Work And Why Theyre Not Enough

To talk about statins, we first need to talk a little about cholesterol. When you hear the word cholesterol, it is referring to one of two sorts.

First, there is blood cholesterol. Most of it comes from the liver. The liver produces cholesterol because our bodies need it for all kinds of reasons. Cholesterol helps our cells do their jobs. It is also an integral part of several hormones. We would not exist without blood cholesterol, but then again, neither would heart disease.

There’s cholesterol in your blood , and cholesterol you eat .

Blood cholesterol is also the number were referring to when we say, My cholesterol level is . . .

Heres one really important point: Our liver manufactures all the cholesterol we need.

The second type of cholesterol is dietary cholesterol. This is the cholesterol we eat. Major sources include egg yolks, organ meats like liver, and shrimp.

If we eat too much dietary cholesterol, we can raise our blood cholesterol somewhat, but what really sends our blood cholesterol soaring are saturated fats and trans fats. Foods full of saturated fat include red meat, butter, cheese, cream, whole milk, palm oil, and coconut oil. Foods with trans fats include anything that has partially hydrogenated oils in its ingredient list, such as many store-bought cakes, pies, and cookies as well as biscuits, donuts, and some margarines.

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Dietary Factors That Tend To Reduce Ldl Cholesterol

Soluble Fiber

Soluble fiber helps to lower blood cholesterol levels. It dissolves in water to form a gel that moves slowly through the intestines, grabbing up fat, dietary cholesterol, bile salts, and sugar to be excreted. Once excreted, these are no longer available to build more cholesterol.

Load up on foods high in soluble fiber like beans, such as hummus, lentil stew, dal, bean burritos, bean soup, bean burgers, bean dips. There are endless options to incorporate beans into your diet. Oats and barley are also high in soluble fiber. Try having steel-cut or overnight oatmeal for breakfast, use rolled oats to make pancakes, or make a delicious barley risotto. Incorporate soluble-fiber-rich vegetables like eggplant, okra, carrots, and potatoes into your diet to help lower cholesterol. This also includes dark, leafy greens such as kale, spinach, and collard greens. Pectin is a soluble fiber that works by binding to fatty substances in the digestive tract, including cholesterol, and promotes their elimination. Pectin-rich fruits such as apples, grapes, citrus fruit, and strawberries can help lower LDL.

Whole Soy

Effect On Statins On Lipid And Lipoprotein Levels

Lowering LDL Cholesterol With Statins [Healthy Hangouts]

The major effect of statins is lowering LDL-C levels. The effect of the various statins at different doses on LDL-C levels is shown in . As can be seen in different statins have varying abilities to lower LDL-C with maximal reductions of approximately 60% seen with rosuvastatin 40mg. Doubling the dose of a statin results in an approximate 6% further decrease in LDL-C levels. The percent reduction in LDL-C levels is similar in patients with high and low starting LDL-C levels but the absolute decrease is greater if the starting LDL-C is high. Because of this profound ability of statins to lower LDL-C levels, treatment with these drugs as monotherapy is often sufficient to lower LDL-C below target levels.

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Effect On Bempedoic On Lipid And Lipoprotein Levels

EFFECT WITHOUT STATINS

In a study that randomized 345 patients with hypercholesterolemia .and a history of intolerance to statin to bempedoic acid or placebo bempedoic acid decreased LDL-C by 21.4%, non-HDL-C by 17.9%, and apolipoprotein B by 15% . One third of patients were on background non-statin therapy most commonly ezetimibe and fish oil. Triglyceride levels were not altered but there was a small decrease in HDL-C levels that was statistically significant .

IN COMBINATION WITH STATINS

Notably, the addition of bempedoic acid to atorvastatin 80mg per day was still capable of significantly decreasing LDL-C , non-HDL-C , and apolipoprotein B compared to placebo . The addition of bempedoic acid to high dose atorvastatin therapy did not cause meaningful changes in atorvastatin pharmacokinetics.

IN COMBINATION WITH STATIN AND EZETIMIBE

People With Cardiovascular Disease Caused By Atherosclerosis

This includes people who have had:

  • A heart attack or other problems from blockage of the coronary arteries of the heart

  • A stroke or mini-stroke or blockage of carotid arteries in the neck

  • Leg pain caused by blockage of peripheral arteries

  • Aneurysm or bulging of the abdominal aorta

The goal of using statins is to prevent further problems, like a second heart attack.

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Effect Of Bempedoic Acid On Clinical Outcomes

Currently there are no outcome studies determining the effect of bempedoic acid on atherosclerotic cardiovascular disease. The effect of bempedoic acid on cardiovascular disease is currently being evaluated in a large ~3.5-year clinical trial . In animal models of atherosclerosis, treatment with bempedoic acid had favorable effects on atherosclerosis . Moreover, genetic variants that mimic the effect of ATP citrate lyase inhibitors lower LDL-C levels and are associated with a decrease in cardiovascular disease suggesting that bempedoic acid will have favorable effects on reducing the risk of cardiovascular disease .

Effect Of Mipomersen On Clinical Outcomes

Pin on Cholesterol

There are no clinical outcome trials but it is presumed that lowering LDL-C levels in patients with Homozygous Familial Hypercholesterolemia will reduce cardiovascular events. In a study comparing cardiovascular events in patients with Homozygous Familial Hypercholesterolemia in the 24 months prior to initiating mipomersen therapy and after initiating mipomersen revealed a decrease in events . In this trial mipomersen resulted in a mean absolute reduction in LDL-C of 70 mg/dL , non-HDL cholesterol of 74 mg/dL , and Lp of 11 mg/dL .

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