Re: Question about Chol. medications

>>SBH,
You made have misunderstood or prohaps I did not explain myself very
well.
I am not sure that I have rhabdomyolysis--just slight muscle and joint
pain. However, after I found out that statin medications can in some
cases
cause rhabodomyolysis--it caused me to wonder. Do you know whether or
not
there are any other medications (other than statins) that are used to
lower tchol. levels? If so, what is the name of the medication. I would

like to stop taking statin medications.
Thanks, <<


COMMENT:

A number of medications lower cholesterol, but some of them don't lower
mortality, so what's the point? For some of them, there's still
argument about whether or not this is due to underpowered studies, or
to other kinds of mortality making up for decreased cardiac mortality.
Some statins are newer than others, and they aren't all alike (there's
a safety issue with the newer ones, due to less experience with them).
Some other classes of drugs lower cholesterol a lot (fibrates) but
can't even be shown to lower cardiac mortality, let alone overall
mortality. You have to get by on decreasing heart attack rate, but the
fibrate studies have not been underpowered, and if that's all they do,
it's not enough, because they are strongly suspected of causing cancer.
Niacin is in the same boat as regards positive effects (which are
modest) but the studies are underpowered and niacin is not as suspect
of being a bad actor. It's a reasonable choice. A better one is fish
oil, though it won't have quite the dramatic effect on cholesterol.
Then again, we're not all that sure an agent MUST have a dramatic
effect on cholesterol, in order to decrease cardiac deaths. There is
pretty good evidence that fish oil does just that, for example.

A lot of what's reasonable to do has to do with your personal risks. If
you know already you have heart disease, it's much more reasonable to
take a statin than if you merely have high cholesterol levels. And the
levels themselves should probably dictate some of what you do. If
you're cholesterol is 400 or even 300 mg/dl you'd better do something,
even if you haven't had a heart attack yet. For 250 it starts to get
dicey. For 220 it starts to depend on whether you're male or female,
etc. So you're going to have come up with more info.

SBH

.

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