Nov. 11, 2009 There seems to be no end to the
research reports unveiling startling new health advantages for those who
take statins, the drugs used primarily to lower cholesterol. The latest,
reported in todays issue of the Journal of the American Medical
Association, says taking statins for more than a year reduces the
risk of gallstones requiring surgery. Not too surprising when you
realize most gallstones are formed from cholesterol.
American Heart Association
reports percentage meeting
cholesterol standards has doubled in decade; study from Netherlands
finds statins can protect nerve cells against damage known to occur in
Alzheimer's
Consumer Reports' chief medical adviser blogs
about recent study showing a cholesterol lowering drug - Crestor - cut
the risk of heart attack and stroke, even in people with normal
cholesterol.
HsCRP is one of the most widely studied markers of
inflammation in cardiovascular disease: statement from the director of
National Heart, Lung, and Blood Institute
In developed countries, approximately 10 percent to
20 percent of white adults have gallstones, which can cause pain and
complications. Gallstone disease is a leading cause of gastrointestinal
tract illness and inpatient admission in western countries and
represents a serious burden for health care systems worldwide. More than
700,000 cholecystectomies (removal of the gallbladder) are performed
annually in the United States, according to background information in
the article.
Gallstones are classified as either cholesterol (80
percent - 90 percent) or pigment stones (10 percent - 20 percent), with
cholesterol stones formed on the basis of cholesterol-supersaturated
bile.
"Statins decrease hepatic [liver] cholesterol
biosynthesis and may therefore lower the risk of cholesterol gallstones
by reducing the cholesterol concentration in the bile. Data on this
association in humans are scarce," the authors write.
Michael Bodmer, M.D., M.Sc., of University
Hospital, Basel, Switzerland, and colleagues conducted a large long-term
observational study to examine the association between statin use and
the risk of developing gallstone disease followed by cholecystectomy.
The study included data from between 1994 and 2008
from the UK-based General Practice Research Database. A total of 27,035
patients with cholecystectomy and 106,531 matched controls were
identified, including 2,396 patients and 8,868 controls who had statin
use.
The researchers found that compared with nonuse,
current statin use (last prescription recorded within 90 days before the
first-time diagnosis of the disease) was 1.0 percent for patients and
0.8 percent for controls for 1 to 4 prescriptions; 2.6 percent vs. 2.4
percent for 5 to 19 prescriptions, and 3.2 percent vs. 3.7 percent for
20 or more prescriptions.
"This large observational study provides evidence
that patients with long-term statin use have a reduced risk of gallstone
disease followed by cholecystectomy compared with patients without
statin use.
However, the odds ratio was not decreased for
patients with short-term statin use but started to decrease after 5
prescriptions, reflecting approximately 1 to 1.5 years of treatment. The
risk estimate was consistent across age and sex groups. Adjustment for
important risk factors for gallstone disease did not materially alter
the results," the researchers write.
The authors add that the observed risk reduction
suggests a class effect for all statins, and that there was a tendency
toward a lower risk of gallstone disease for high-dose statin use
compared with low-dose exposure. A substantially increased gallstone
risk with cholecystectomy was found for patients with high body mass
indexes and for patients with estrogen use.
"Our findings may be of clinical relevance given
that gallstone disease represents a major burden for health care
systems," the researchers conclude.
