|
E-mail this page to a friend!
Senior Citizen Health & Medicine
Senior Citizens Face Added Cancer Risk from Low
Cholesterol or Maybe Statins
Statins lower cholesterol for heart protection but
maybe there is a limit
July 24, 2007- Millions of senior citizens take
statins to lower their cholesterol and almost everyone believes that
lowering low-density lipoprotein (LDL) cholesterol, and achieving lower
LDL cholesterol levels is one of the most important steps in preventing
heart disease. New research, however, provides evidence that low LDL
levels may be associated with cancer risk, but leaves a major questions
is it the statins or the low cholesterol causing the problem?
The authors of the study, published in the July 31,
2007, issue of the Journal of the American College of Cardiology (JACC),
set out to understand how and why statins cause side effects,
particularly damage to the liver and muscle cells.
The study findings support taking multiple
medications rather than high-dose statins to minimize those side
effects, according to the authors.
The researchers did not expect to find the
increased cancer risk (one additional incident per 1,000 patients) from
low LDL levels, and additional studies have already begun to investigate
this potential risk further.
A key component in future studies will be to
confirm the risk and to identify whether the risk may be a side effect
of statins or just low LDL.
This analysis doesnt implicate the statin in
increasing the risk of cancer, said lead author Richard H. Karas, M.D.,
F.A.C.C., professor of medicine at Tufts University School of Medicine.
The demonstrated benefits of statins in lowering the risk of heart
disease remain clear; however, certain aspects of lowering LDL with
statins remain controversial and merit further research.
The researchers found one additional incident of
cancer per 1,000 patients with low LDL levels when compared to patients
with higher LDL levels. In their evaluation of randomized controlled
statin trials published before November 2005, the researchers looked at
13 treatment arms consisting of 41,173 patients.
Researchers assessed absolute change and percentage
of change in LDL reduction and the resulting achieved LDL levels in
relation to rates of newly diagnosed cancer in each treatment arm.
They also looked at the relationship between low,
intermediate and high doses of statins and rates of newly diagnosed
cancer. Although they did not find a relationship between percent of
change and absolute change in LDL levels, they observed higher rates of
newly diagnosed cancer among patients with lower achieved LDL levels. In
addition, the new cancers were not of any specific type or location.
Recent data from large-scale statin trials have
shown that more intensive LDL lowering can provide significant
cardiovascular benefits to higher-risk patients. In response to these
findings, recent national guidelines have advocated for lower LDL goals
and higher doses of statins to reach them. However, informal
observations linking intensive LDL lowering and higher incidence of
reported health problems, including liver and muscle toxicity and
cancer, has introduced some concern over the safety of such treatments.
These concerns in part prompted the current study.
However, the current findings are not definitive, as limitations of the
study show. Researchers performed their analysis from summary data taken
directly from published manuscripts of each trial. An analysis based on
data for each individual patient would have yielded more specific and
potentially more compelling results, said Dr. Karas.
These current findings provide insufficient
evidence that there is any problem with LDL lowering that outweighs its
significant benefits on vascular disease, said John C. La Rosa, M.D.,
who wrote an accompanying editorial in the July 31 issue of JACC.
However, we must continue to be vigilant in ensuring that its benefit
clearly outweighs its risk.
Other Statin Side Effects
Although the cancer risk was surprising, the
researchers primarily sought to determine how and why statins cause side
effects, particularly damage to the liver and muscle cells. For this
portion of the study, researchers analyzed 23 statin treatment arms that
included 75,317 patients with a combined 309,506 years of follow up. A
link between LDL lowering and liver or muscle irritation was not found.
However, liver toxicity levels increased with
higher statin dosage. Based on their findings, the researchers concluded
that moderate-dose therapy with multiple medications including statins
may prove to be preferable to high-dose therapy with statins alone. Dr.
Karas emphasized that patients are advised to continue their statin
treatments and, as always, consult their doctor before discontinuing use
of any medication.
While these results raise important new questions
about statin use, they do not demonstrate a causal relationship between
statins and cancer, said James Dove, M.D., F.A.C.C., president of the
American College of Cardiology. This study is hypothesis-generating,
not hypothesis-proving.
Editors Notes:
The American College of Cardiology is leading the
way to optimal cardiovascular care and disease prevention. The College
is a 34,000-member nonprofit medical society and bestows the credential
Fellow of the American College of Cardiology upon physicians who meet
its stringent qualifications. The College is a leader in the formulation
of health policy, standards and guidelines, and is a staunch supporter
of cardiovascular research. The ACC provides professional education and
operates national registries for the measurement and improvement of
quality care. More information about the association is available online
at
http://www.acc.org .
The American College of Cardiology (ACC) provides
these news reports of clinical studies published in the Journal of the
American College of Cardiology as a service to physicians, the media,
the public and other interested parties. However, statements or opinions
expressed in these reports reflect the view of the author(s) and do not
represent official policy of the ACC unless stated so.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
