Are statins right choice to decrease heart-attack risk?
Q. I'm 50 years old and have high cholesterol (225 total, 140 LDL). I exercise and have a good diet. My triglycerides, blood pressure and heart rate are all low. I discouraged my doctor from having me go on a statin drug, so she recommended CholestOff. Whatever I decide to take is obviously something I will have to take for the rest of my life. What can you tell me about CholestOff? Are there any other options?
N.S., via e-mail
A. Many people have high total cholesterol but are reluctant to embrace a lifelong relationship with statins. The logic of such concerns is not something that can be decided in a newspaper column; it's an individual decision that needs to be made in consult with one's personal physician. There is evidence that statins can decrease the risk factors associated with coronary heart disease. But are statins right for everyone? I encourage everyone to check out the American Heart Association's risk-assessment tool, as noted in the question above.
CholestOff is a dietary supplement that contains plant sterols/stanols. These are compounds that have been shown to inhibit cholesterol absorption when consumed before a cholesterol-containing meal. These are the same compounds present in a number of cholesterol-lowering margarines. Research evidence indicates that these compounds can work for some. The February 2008 issue of the Journal of the American College of Nutrition contained a review of studies that looked at these compounds. It reported a reduction of risk factors for all, but those with higher baseline levels of total and LDL cholesterol tended to experience the greatest benefit. You and your doctor will have to decide whether it's appropriate to give these compounds a try.
Getting back to the drugs, taking a statin or any cholesterol-lowering drug is an artificial means to correct a symptom of imbalance in the body. Whether due to a genetic predisposition, poor diet and/or lifestyle, cholesterol and other risk factors become elevated for a reason. It makes little sense to dismiss the problem thinking that a pharmaceutically lowered cholesterol level fixes everything. It may reduce some elements associated with the risk, but it does not relieve us of the responsibility to treat our bodies with care. If you need medication, by all means, use it. It would be a worthy goal to make the appropriate changes so that the need for the medication is reduced or eliminated.
• Ed Blonz, Ph.D., is a nutrition scientist and the author of "Power Nutrition." Write him at Ed Blonz, c/o Newspaper Enterprise Association, 200 Madison Ave., New York, NY 10016. For e-mail, address inquiries to: ed@blonz.com. Due to the volume of mail, personal replies cannot be provided.