When I was in General Practice in Australia, the cholesterol-lowering drug
Simvastatin became available. After telling patients to cut down on animal fats
to lower their cholesterol, there was now a drug that could help.
I was never one to be the first to prescribe new ‘wonder’
drugs, but with the cardiologists sending patients back on this drug regimen, I
too began to prescribe it. Simvastatin became one of the drugs I enjoyed
prescribing most - it actually did work! Not that other prescribed medications
did not work, but Simvastatin produced an amazing lowering of the body’s burden
of cholesterol very quickly. And every time.
However, the long term results of any drug use are sometimes
difficult to demonstrate at first. After many years, does your blood pressure go
through the roof? Or do your dangly bits fall off? In some instances it could be
a case of ‘wait and see’. However, as far as is possible, the results of longer
term usage are looked at through many ways, including animal testing. The poor
old laboratory mouse is flat out keeping numbers up to scratch!
There is just so much information to collect - there are
epidemiological results found from over hundreds of thousands of cases and
critically reviewing the results at the end. This is one of the ways that
differentiates between the pharmaceutical industry and the “alternative”
industry.
Now, a startling fact has emerged from one of the longer term
examinations of statin usage. It appears that statins safely reduce the risk of
cardiovascular illness even years after treatment is stopped, according to a
probe into the popular cholesterol-lowering group of drugs published in
November.
A look at the background is justified here. Statins work by
blocking a liver enzyme that makes fatty molecules, which line arterial walls
and increase the danger of heart disease and strokes. With worldwide annual
sales of more than 20 billion dollars, the drugs have been dubbed “the aspirin
of the 21st century” because of their benefit and wide use. However, lingering
questions persisted about their long-term safety for the heart, liver and cancer
risk.
In this latest examination, researchers at the Heart
Protection Study Collaborative Group in Oxford in the UK looked at 20,536
patients at risk of cardiovascular disease who were randomly allocated 40 mg
daily of simvastatins or a dummy look-alike (known as placebo’s) over more than
five years.
During this period, those who took the statins saw a
reduction in “bad” cholesterol (LDL) and a 23 percent reduction in episodes of
vascular ill-health, compared to the placebo group. The exhaustive study did not
end there. The monitoring of the volunteers continued for a further six years
after the trial ended. The investigators found that the benefits persisted
throughout this monitoring period even among those volunteers who had stopped
taking the statins. Now that is somewhat amazing. In addition, there was no
emergence of any new health hazard among those who had taken, or were continuing
to take, the drugs.
“The persistence of benefit we observed among participants
originally allocated simvastatin during the subsequent six year post-trial
period is remarkable,” said one of the investigators, Richard Bulbulia.
As far as cancer incidence was concerned, a number of cancers
(nearly 3500) developed amongst the 20,536 volunteers during this follow-up
period (roughly one in six), but there was no difference in cancer incidence
between the statin and placebo groups.
Richard Bulbulia continued, saying, “In addition, the
reliable evidence of safety, with no excess risk of cancer or other major
illnesses during over 11 years follow-up, is very reassuring for doctors who
prescribe statins and the increasingly large numbers of patients who take them
long-term to reduce their risk of vascular disease. A previous investigation in
November 2010 found that long-term use of statins was less risky than thought
for people with non-alcoholic fatty liver disease (NAFLD), a common liver
ailment.
So what does all this mean as far as cardiovascular disease
is concerned? It has been shown, beyond doubt, that LDL cholesterol is a major
factor in coronary artery disease. It has now been shown that statins do reduce
LDL, do reduce your risk, and appear safe and have lasting benefits.
