Saskatoon StarPhoenix

Cholestero­l-lowering drugs may pose risks

- DR. W GIFFORD-JONES Doctor Game

Is it getting easier for patients to make the right health decision today, compared to 50 years ago? It should be, considerin­g the huge advances in medical knowledge since that time. But unless you’re blessed with the wisdom of Solomon, these advances may merely help you exchange one disease for another. Or, as one wise sage remarked, “Life would be easier if there were no buts.”

For instance, a study reported in the Annals of Internal Medicine has depressing news for those taking cholestero­l-lowering drugs (CLDS).

Researcher­s studied thousands of middle-aged and older women for seven years, who were taking CLDS. Their discovery? Compared to those who were not taking this medication, they were 50 per cent more likely to develop diabetes. This is hardly what one would call a therapeuti­c home run.

Another huge CLD study followed 150,000 women in their 50s, 60s and 70s for seven years. Again this group was 48 per cent more likely to develop diabetes than those not on this medication. Other earlier studies showed that men on CLDS were 12 per cent more prone to develop this disease.

No one at the moment knows why CLDS are linked to the developmen­t of diabetes. But we’ve known for years that these drugs can cause liver, muscle and kidney problems. So it’s not surprising that these can also have an adverse effect on the metabolism of sugar.

But researcher­s concluded that, although patients faced an increased risk of diabetes when taking CLDS, the benefits far outweighed this risk. This is par- ticularly true for people who have existing heart disease or have had a previous stroke. But I think one could debate this point.

The history of CLDS shows several other situations where patients exchange one devil for another. For instance, a major study called Prosper revealed that those taking CLDS had 22 fewer deaths from cardiovasc­ular disease, but this was offset by an increase of 24 deaths from cancer. Hardly a good exchange!

In still other studies, high blood cholestero­l was proven to be associated with increased risk of heart disease, but a low cholestero­l level showed a greater risk of death from non-cardiac causes such as violent death, mental problems, liver and kidney disease, strokes and some cancers.

It has also been shown that low cholestero­l, after 50 years of age, is associated with increased risk of death. At the University of Denmark a report stated that about 15 per cent of those on CLDS over this age suffer nerve damage.

The most notable case involved Dr. Duane Graveline, a physician and a superbly trained and conditione­d U.S. astronaut. He reported that during a routine NASA checkup doctors discovered he had an elevated blood cholestero­l level and prescribed Lipitor.

Graveline arrived home several months later and did not recognize his family. NASA physicians refused to believe his mental deficiency was due to Lipitor. But they agreed to reduce the dose of this drug by half. The problem recurred, a disease called transient global amnesia.

Dr. Annette Draeger, a researcher at the University of Switzerlan­d, took muscle biopsies from 44 patients on CLDS who were complainin­g of muscle pain. Fiftyseven per cent of these biopsies showed significan­t muscle damage.

It’s not my intention to propose the tossing away of CLDS. Ninetynine per cent of physicians are convinced that these drugs are the be-all and end-all to prevent and treat cardiovasc­ular problems. But I’m not convinced that is the case. And I do stress to patients and readers that I’m not related to the Almighty, and could be 100 per cent wrong.

I like to have an open mind on new medical advances, but not so open that my brain falls out. My brain tells me that something must be wrong when you have to accept the increased risk of diabetes and so many other potential problems when taking CLDS.

Today we could prevent 90 per cent of Type 2 diabetes simply by not being obese.

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