Posted on 11/08/2023 9:57:40 PM PST by ConservativeMind
Moderate-intensity statin with ezetimibe combination therapy was confirmed to be effective on low-density lipoprotein cholesterol (LDL-C) reduction in patients at very high risk of atherosclerotic cardiovascular disease. The research team found out that the therapy has a higher compliance rate than the conventional high-intensity statin monotherapy.
In order to prevent the recurrence of myocardial infarction or stroke, it is crucial to maintain LDL-C levels lower than 55mg/dL or 70mg/dL for patients at a very high risk of atherosclerotic cardiovascular disease. Statin drug therapy is the most often used.
However, continued treatment with high-dose statin may cause a high risk of side effects. This is why the long-term administration of high-dose statin was difficult and the safety of treatment an important task.
The research team analyzed and compared the treatment effects of moderate-intensity statin with ezetimibe combination therapy and high-intensity statin monotherapy in 1,511 patients at very high risk of atherosclerotic cardiovascular disease.
Patients at very high risk of atherosclerotic cardiovascular disease are defined as patients with 12 diseases, including a history of myocardial infarction, peripheral artery disease, and high blood pressure. The patients were randomized into two treatment arms and followed for three years.
The analysis of LDL-C on both treatment arms during the observation period showed 57mg/dL for the combination therapy arm and 65mg/dL for the monotherapy arm. The former represented a greater reduction of LDL-C. The complication incidence such as heart failure, myocardial infarction, and cerebral infarction for the combination therapy arm was at 11.2% which had no significant difference from the monotherapy arm (11.7%).
A more important aspect was intolerance to medication. The rate of discontinuation for the combination therapy arm was 4.6%, which was lower than 7.7% for the monotherapy arm. This proved the former is more advantageous in terms of continuous medication dose.
(Excerpt) Read more at medicalxpress.com ...
So the doctor puts seeming healthy people on these and then suddenly their health declines rapidly and then they die. It happens in some people. I have seen it.
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I am one data point that supports that. The combination of a low dose statin with ezetimibe lowered my high cholesterol down to 108 in my last test.
And low cholesterol is good? Cholesterol is the mother hormone. Without it,?you die.
And low cholesterol is good? Cholesterol is the mother hormone. Without it,?you die.
To a degree, you are correct. However the lower limit of cholesterol (LDL) that is necessary is unknown. Traditionally it was said that the LDL fraction should be below 100mg/dl. If the patient had vascular occlusive disease (coronary, cerebral or peripheral arterial involvement) it was recommended to maintain an LDL less than 70 mg/dl in order to decrease progressive or recurrent issues. Statins lower the LDL in a somewhat dose-dependent manner. However more than a few patients can not tolerate the STATINS for whatever issue (frequently musculoskeletal) so the drug Zetia has been advised to further the effect of the statins (a booster so to speak!). Zetia without the statin is pretty useless. Newer injectable meds (PCSK-9 inhibitors), like Repatha are much more effective in lowering the LDL especially in those with quite high LDL levels seen in familial hyperlipidemia. They are much more expensive and at least initially were quite difficult to afford as insurers were reluctant to approve and cover their costs.
Recent studies, primarily from Europe have shown that the optimal low level of LDL to attain in order to optimize risk reduction is much lower than the 70 mg/dl that has been the traditional goal. Levels as low as 30-40 mg/dl are now touted as the goal and that level is almost impossible to attain without the use of the PCSK-9 meds.
This report interestingly showed no reduction in “events” despite the slightly lower levels of LDL in those who were given combination therapy (statin plus Zetia) which at least in that study showed the slight changes did not add benefit to the patient.
The bottom line is - talk to your doctor - Internist or Cardiologist - about what your goal level should be - discuss life-style and the changes that may need to be made - don’t use tobacco - exercise at least moderately, take your other preventative meds like low-dose aspirin, blood pressure meds etc as prescribed.
By the way, the European studies do not show any adverse effects from having LDL levels down to the 30mg/dl level (although some speculation has been made regarding psychiatric effect). So we don’t know the “optimum lower level of LDL” at this point in time. It does appear that “Lower is Better!”
High cholesterol seems to have contributed to the early deaths of most of my mothers side of the family. It was rare to see any of them make it out of their mid 60s. There is a balance of too high and too low. For my family too high seems to be a killer.
My aunt had cholesterol levels in the 300s as do I (it has been “high” as long as I can remember) and my cousin. My aunt passed away in her late 80s. My cousin and I are in our 70s. I am blessed with great health and hope that continues. I take a number of supplements that are recommended to positively affect cardiovascular health. No statins for me.
thanks for posting this.
I’m taking the low dose statin with ezetimibe.
My ldl is currently 47 my hdl is 48 an my vldl is 9.
Here’s hoping that keeps the plaque in my carotids stable.
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