Practical Practitioner
By: Pamela Egan, FNP-C CDE
Stopping cholesterol-lowering medication can be deadly
Dear Pam,
My doctor has recommended that I stay on cholesterol lowering medication, but with all the warnings that it affects the liver, I dont want to continue them. My father died from a heart attack and several family members have died of strokes. What’s your opinion?
Medicine has shown a reduction in heart disease and heart-related deaths. Unfortunately, the media chooses to focus on the negative aspects of treatment rather than the number of deaths prevented from heart attacks and strokes. All medications come with side-effects and precautions. Diseases such as diabetes and high cholesterol that go untreated come with greater risks of death. Would you prefer to have a blood test for liver enzyme drawn quarterly or be paralyzed in bed from a stroke? As long as your blood test for liver enzymes is normal, the risks from taking cholesterol medications are minimal.
If you are an alcoholic, have a history of hepatitis, cirrhosis, liver cancer or other liver ailments, you should not take cholesterol lowering medication. Only you can decide which risks are greater.
New research shows that stopping cholesterol-lowering statin drug therapy in people with heart disease can dramatically increase their risk of death. The study found patients who discontinued using the drugs when they were hospitalized for chest pain were three times as likely to have a heart attack or die than those who kept taking their medications.
Researchers say the study adds evidence that statins may do more than just lower cholesterol, and that the drugs may protect the heart in other important ways.
For example, recent research has shown that statins can reduce harmful inflammation in the arteries that can lead to blood clots.
This study, published in Circulation: Journal of the American Heart Association, supports the idea that statins increase the release of protective nitric oxide in the inner walls of the heart.
Research has shown that when the statins are suddenly withdrawn, a rebound effect occurs, and the nitric oxide levels drop below normal- increasing the risk of heart attack or other cardiac events.
Of the 465 patients who had been taking a statin drug for six months when admitted to the hospital for chest pains, 379 continued taking the drug, and 86 stopped.
After 30 days, researchers looked at the number of patients who died or suffered a heart attack.
People who were kept on their statin medication had half the risk of death or a nonfatal heart attack than those who had never taken a statin drug.
Those who stopped using statins at hospitalization had nearly three times the risk compared with those who continued using medication.
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