Half of statins patients don't hit 'healthy' cholesterol levels

PARIS, France - Millions of patients around the world taking statins to lower the risk of heart disease fail to achieve the recommended levels of cholesterol reduction after two years of treatment, new research said Monday.

Statins -- a class of medicines designed to reduce cholesterol linked to heart disease and strokes -- are among the most commonly prescribed drugs in the United States and Britain.

The cholesterol-lowering industry is worth billions of dollars, but guidelines over who should take statins are often unclear.

A team of researchers in Britain reviewed public health records of 165,000 patients taking the medicine and found that fewer than one in two reached the recommended "healthy" 40 percent cholesterol reduction within two years.

"Statins do work and are effective, but some trials have highlighted there have been variations in responses among some patients," said Ralph Kwame Akyea, research associate at the University of Nottingham's Faculty of Medicine and Health Sciences.

"But we've shown there are some people not reaching this (safe cholesterol level) and the reducing of their risk is lower," he told AFP.

Akyea's study, published in the journal Heart, found that people on average started taking statins aged 62. It found nearly 23,000 cases of cardiovascular disease within six years of statin treatment among patients. 

In total, 51 percent of patients had an insufficient drop in cholesterol even while taking the drugs. 

Akyea stressed that the study -- the largest of its kind to date -- could not establish why some patients responded positively to statins while others didn't.

"Probably some people would have stopped taking their medication, maybe they had side effects," he said. 

"There might also be a role played by genetic variation. Not everyone responds to the medication and there are currently studies looking at the genetics of drug response."

MILLIONS MORE PATIENTS EXPECTED

Recent changes to prescription guidelines are set to see statins given to more than 55 million people in the US and 12 million people in Britain in the next few years.

Akyea and his team suggested that better guidance and monitoring was needed to ensure those given statins were taking the correct doses for the prescribed amount of time. 

Writing in a linked editorial, Marcio Bittencourt, from Sao Paulo's University Hospital, said the study's results were "clearly alarming". 

He stressed, however, that statins had been shown to significantly reduce the likelihood of heart attacks and strokes in a large percentage of at-risk patients. 

"Patients and society should be educated on the scientific evidence documenting the benefits of lipid lowering therapy," said Bittencourt. 

"Anti-statin propaganda based on pseudoscience should be strongly disavowed."

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source: news.abs-cbn.com

How pain relievers can harm the liver

MANILA -- The health of a person's liver can be determined through the level of certain enzymes in the body, a gastroenterologist explained on Tuesday.

On radio DZMM's "Magandang Gabi Dok," Dr. Edward Lim, a gastroenterologist from the Chinese General Hospital, said a person can determine if his or her liver is healthy by undergoing a routine blood test.

He said this can be done by determining the level of serum glutamic-pyruvic transaminase (SGPT) or serum glutamic-oxaloacetic transaminase (SGOT) in the blood.

Both SGOT and SGPT are enzymes that can be found in a person's liver.

"Marami kasi sa mga pasyente, kapag nagpa-routine blood examination, lumalabas na mataas ang katas sa atay. Ibig sabihin, may problema sila (sa atay)," Lim said.

If the SGPT is higher than the SGOT, then it means that there is something wrong with the liver.

However, if the SGOT is higher than the SGPT, then it means that there is something wrong with the tubes of one's liver.

Lim said people who often consume alcoholic drinks usually have higher levels of SGOT in their blood, which means they might have problems with the tubes on their liver.

"Sa tubo ng atay dumadaan ang mga katas o enzymes papunta sa small intestines. 'Yung bile, tumutulong sa digestion. Kapag may bumabara sa tubo ng atay, hindi makakalabas yung enzymes, mamamaga siya," he added.

On the other hand, a person with higher levels of SGPT in his blood may have liver problems such as hepatitis, fatty liver, or a damaged liver caused by medication.

Lim explained that all medicines are metabolized either in the kidney and liver, and may have bad effects on the organs if taken beyond the recommended dose.

"Medicines hit the liver or the kidney. Kailangan silang ilabas, otherwise, nagiging toxic. Kapag sobra ang dosage, nakakasira ng kidney o atay."

Some medicines that affect the liver are pain relievers like acetaminophen and paracetamol, and medication used to cure tuberculosis.

Lim clarified that these medicines can only affect the liver if the person takes more than the required dosage.

He said this is a common problem in the US and Europe, but is uncommon in the Philippines.

"Sa Pilipinas hindi masyadong problema kasi marami, hindi compliant sa gamot. Minsan kahit 1 linggo dapat, iinumin lang ang gamot, 2 araw," Lim said.

Some people, especially those who are overweight, or have a diet high in fat, may suffer from fatty liver.

"Nagkakaroon ng fatty liver kapag hindi na alam ng liver kung anong gagawin sa excess fat. Namamaga ang atay, nababalutan ng taba. 'Yung mga pagitan ng cells ng atay, may taba," Lim added.

He also explained that men should have an SGPT below 30, while women should have SGPT below 20.

Those who want to know if they have problems with their liver should undergo a blood test, and have their liver enzymes checked.

source: www.abs-cbnnews.com