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“Heart-Breaking” ExcusesBy: V. Deborah Culligan, RN, MPH, Many people seem reluctant to take prescription medication for lowering their cholesterol. The most common reasons are: 1) “I don't like to take medication.” Or 2) The medications are expensive. While number 2 is understandable, number one is puzzling. No one likes to take medicine. Furthermore, liking medicine really has nothing to do with WHY we take the medications that we take. Medicines are not meant to be enjoyed. What people don't seem to realize is that we have an arsenal of medications along with the knowledge with which to combat heart disease and strokes. It makes no sense that people would refuse medication, based on a dislike of medication. And ironically, many of these same many people are willing to take nutritional supplements or health food remedies that are largely untested, unstudied, expensive and mostly worthless! Recent reports in the news media may contribute even more to your “suspicions” about drugs. Vytorin, a combination of two drugs, Zetia (ezetimibe-which is not a statin drug) and Zocor (simvastatin) has come under scrutiny for its ability to produce a decrease in cardiovascular risk any better than Zocor by itself. This question is being examined as a result of some research that has been conducted. However, the final verdict will probably not be in until 2011 or 2012. Many health professionals are currently recommending not using Vytorin, unless their patient can't tolerate traditional statin drugs. This issue with Vytorin should NOT be used as an excuse to not take a statin drug if it is prescribed for you. And we should consider ourselves lucky to live in a culture where questions like this are raised and examined. Statin drugs for lowering cholesterol are truly among the great discoveries for cardiac health. While preventing a cardiovascular event can add years to your life, it is not just about length of life. It is also about quality of life. These drugs can allow you to continue to be active and functional, by preventing debilitating heart disease. This is why they are useful even in the elderly. So what do you do when your doctor tells you that you should begin taking a “statin” drug for your cholesterol? A few years ago, he told you that your level was o.k. Now he says you need to lower it. Why? The suspicious among you will think that your health care provider has stock in a pharmaceutical company. However, those who keep up with medical news will know that the level for intervention for treating cholesterol has been lowered, especially with regards to the level of bad cholesterol (LDL.) Furthermore, continuing research has demonstrated the success of statin drugs in the campaign against heart disease. Most of the drugs used today to treat cholesterol are in a family called “statins” but there are other drug families used as well. Statin drugs are usually the preferred drugs. Simply stated, these drugs work by inhibiting a specific enzyme that is needed to produce cholesterol. They can dramatically reduce LDL levels by 20 to 60% and with higher doses can dramatically reduce triglycerides. Overall, they are relatively safe drugs, with minimal side effects. True, some people can not take them. (This is true for any drug.) However, most can take these drugs and gain their benefit while not suffering from side effects. Your doctor will monitor blood levels of the drug over the course of your treatment. Most often, statins, like blood pressure medications, are taken for long periods of time. They are not drugs that you take for a couple of weeks and then go off. Over time, your doctor may lower a dose, alternate days or even try to discontinue it, depending on other interventions you have made (such as quitting smoking or increasing exercise.) But understand, statins are taken for the long-haul. They are not to be taken just when you feel like taking them. There are lifestyle changes such as diet modification and exercise that are certainly worth trying before rushing to cholesterol medications. However, a health care provider generally assesses your overall risk for cardiovascular disease. If that provider deems that your risk factors, which include your cholesterol measurement, are significant, the provider may not want to wait to begin statin drugs. Lifestyle changes take time. You may not have the luxury of waiting that time out. Furthermore, medications and lifestyle changes go hand in hand. Even if you are given medication, you should still try to improve dietary habits and physical activity levels as together you can achieve the “healthiest” effects. District residents can receive free written materials on cholesterol-lowering drugs and lifestyle interventions by calling QVHD, 248-4528 or requesting via email, info@qvhd.org
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Quinnipiack Valley Health District |
Phone. (203) 248-4528 |
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