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New Study: Effectiveness of Popular Cholesterol Drug Questioned

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The New England Journal of Medicine, in November of 2009, published a study that questioned the effectiveness of Zetia (brand name for ezetimibe) and Vytorin (a combination of a statin drug and Zetia) in lowering cholesterol, reducing plaque, and reducing heart attacks and strokes. Both drugs are marketed by Merck. These drugs have a different mechanism for lowering cholesterol than statin drugs. They work by blocking the absorption of cholesterol from food in the intestines, and they were marketed for people already taking Statin drugs that were not achieving the desired results.

The study evaluated the effectiveness of these drugs compared to Niaspan, the long-acting form of the common B vitamin, Niacin. The results showed that the patients taking Niaspan had significantly less plaque in their arteries and higher levels of HDL, the so-called “good” cholesterol.

The patients taking Zetia had lowered LDL, the “bad” cholesterol. However, they also had more plaque in their arteries and more heart attacks, strokes and cardiovascular problems than the patients taking the Niaspan.

Two other studies last year also did not bode well for Zetia and Vytorin. One, actually released by the drug-maker, Merck, showed that these drugs did not reduce plaque formation in arteries as earlier claimed. Another study showed a potential increase in cancer risk among patients taking Zetia and Vytorin.

What Are Some Conclusions?

Cholesterol-lowering drugs are extremely over-prescribed. I am seeing clients with lower and lower levels of cholesterol being scared into taking these drugs. As I have stated many times before, a high LDL cholesterol can almost always be completely reversed with diet and lifestyle changes. Of course it does require a willingness to make changes.

In doing so, one can actually REVERSE the mechanism, or the cause of why the body is making too much cholesterol

It’s critical for us to understand the body as a system. This means that higher cholesterol often occurs in conjunction with high blood sugar, high triglycerides, high blood pressure, high levels of stress hormones or increased inflammation. Taking a medication to lower the cholesterol does not necessarily reverse the mechanism causing this disorder as well as the others mentioned.

In fact, some have compared using medication to “turn off” the body’s production of cholesterol to reaching behind the dashboard of your car and disconnecting the warning oil light instead of investigating the cause of the low oil.

I don’t believe anyone should be told to take a Statin or other cholesterol-lowering drug without first having a full risk assessment. That includes a VAP test (also goes by other names from various labs). A VAP not only measures LDL and HDL but measures the particle size and specific types of these cholesterols. It is a much more up-to-date, accurate and thorough assessment of risk. And, the results of these more detailed tests would better inform appropriate therapy. In addition, there are 4-5 more risk level assessments that should be evaluated as well. All are simple blood tests.

I say let’s get all the information and make the best therapy decisions. That way, we are not just lowering a number, but reversing a mechanism that is causing the underlying dysfunction.

Please know I am happy to coach you in reducing your risk of a heart incident. In addition to helping with lifestyle and diet changes to reverse a disease mechanism, I will also help make sure you are getting all the appropriate tests and assessments. I’ll also evaluate your test results — not simply to determine if they are “normal” but also whether your levels are optimal for keeping you healthy and reducing risk. Please call to make an appointment if this is an area you want and need to explore.