Intensive Statin Drug Therapy to Lower Blood Lipids
The importance of lipid therapy in the cardioprotective and treatment aspects of heart disease is well documented, particularly in the elderly population. Statins have been used along with diet, to control lipids for years.
More recent studies have lowered the recommendations from < 100 for LDLs to < 80 or <70 mg/dl. The authors state that more intensive statin therapy has resulted in more marked cardiovascular event reduction. The authors, in particular, review the safety and efficacy of intensive vs. less intensive statin therapy. Their studies reviewed that safety and efficacy standards were met for dosages of 80 mg./day. Dietary intervention was not a variable considered here.
Their conclusions were that although elderly patients generally have more drug interactions when receiving high doses of statins, the present evidence supports the use of intensive statin therapy in most high-risk elderly patients both with CHD and the accompanying acute coronary syndrome. Apparently this was despite the drug interactions.
This study was poorly constructed. Nutrition, an important variable, was not even considered. Nutrition is the first line of therapy in a lipid reduction program and is backed by the Drug Manufacturers as a prerequisite to taking the drug. Coenzyme Q levels were not monitored (often low in statin therapy), results cannot be extrapolated to other age groups;& study sizes were too small to be significantly applicable to clinical practice. Clearly, more focused study needs to be conducted assuring that nutrition intervention, which is always indicated as a first line of therapy, be considered as a variable in the analysis of results. Then the combined use of nutrition plus statins and intensive statins themselves could be studied. The results of all of the studies could then be compared. A statistically significant sample size should be chosen based on the statistical power decided upon and the design of the study. Analysis of the weaknesses of this study can contribute to better designed studies.
Reference: Am J Geriatric Cardiology 2008;17;92-100
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About the Author
Kathy Shattler received her Master of Science degree from Michigan State University in E. Lansing Michigan in Human Nutrition. Her twenty-two years of practice includes holding positions as a Lecturer, Chief Clinical Dietitian and Program Manager. Kathy is the Founder of Nutri-Care Consulting and is currently the Nutrition Director of www.CEU4U.COM, an online continuing education management company for Registered Dietitians and Dietetic Technicians.
