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Lipids

  • Cholesterol is a naturally occurring fat that is not soluble in water, unless bound to a water soluble substance e.g a phospholipid or protein.

  • Cholesterol is essential to life because it’s a component in cell membranes, and is a precursor for steroid hormones and bile acids.

  • However, excessive levels of cholesterol in the blood lead to accumulation of cholesterol in the arterial wall and lead to atherosclerosis- gradually causing blockage of the body’s arteries- especially the ones in

    • Heart muscle ( coronary arteries) (angina, heart attack, and heart failure)

    • Brain ( the carotid and vertebral arteries) (stroke)(dementia)

    • Legs ( the iliac and femoral arteries)

    • Kidney s ( the renal arteries).

Statins lower cholesterol

 

Statins in Australia.

  • An international “meta-analysis” of 14 large trials on statins involving 90 000 patients found a 19% reduction in coronary mortality and a 21 % reduction in any major vascular events.

  • In specific populations, they can reduce the risk of death over five years by 14 to 28%.

  • It has been estimated that up to 2 million Australians use statins.

  • Most people have no side effects of statins, the side effects most commonly reported have been muscle aches, mild GI symptoms, headaches, insomnia, dizziness and elevation of some liver enzymes.

  • The “ Australian Medical Handbook” does not list memory loss as an effect of statins.

  • A recent study looking at all literature published on statins , found 60 individual case reports of memory loss with statins worldwide.

  • The American FDA ( Food and Drug Authority) made headlines recently after revising safety labelling information for statins-

    • they stated that there have been some case reports about effects on memory and blood sugar levels, and that these risks be added to the risk data sheet when you buy the prescription.

    • They advised that the benefits of statins outweigh these risks, and recommended that people continue using them.

    • Despite this recommendation by the FDA, the Australian press over the last few weeks has chosen to highlight potential problems of statin use.

  • Patients over 65 should cease there statin when taking a macrolide because of the risk of kidney injury

  • Statin rx in pts <75 should be based on their absolute CVD risk.

    • (CVD is still the most common cause of death in Australia).

    • Causing 1/3 of deaths in 2008.

  • Statins are the most effective lipid lowering drugs.

  • The benefit is greatest for those with the highest risk.

www.cvdcheck.org.au

  • Drink green tea- tannins may lower cholesterol.

  • Eat more beans

  • Exercise regularly

  • Minimise animal fats

  • Take psyllium

  • Eat fish

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