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Relatively high doses of copper may help reverse unhealthy enlargement of the heart, according to a new study published in the Journal of Experimental Medicine. The research was led by scientists at the University of Louisville Medical Center in Kentucky, in collaboration with Agricultural Research Service scientists from the Grand Forks Human Nutrition Research Center in North Dakota.

The researchers fed a group of mice with enlarged hearts the equivalent of three times the human recommended daily allowance of copper. The mice that had been fed copper experienced a reversal of cardiac hypertrophy — enlarged heart — symptoms, whereas the non-supplemented mice did not.

This is the first study to exhibit such an effect, and other scientists have not yet replicated it. In addition, it is still unknown if the effect would translate to humans. Nonetheless, the scientists are optimistic. They point out that while the doses used in the study are high, they are “well below today’s safe upper limit for copper.”

Copper is a naturally occurring element that is essential for human health. It is needed for various enzymes, for biological electron transport and for aiding in iron uptake. Copper deficiency can produce anemia-like symptoms.

However, the metal can be toxic in high quantities, producing symptoms similar to that of arsenic poisoning. In addition, the human digestive tract appears to have a very limited ability to distinguish between zinc and copper. This means that excessive intake of one of these essential nutrients can lead to deficiency in the other.

The maximum safe level for copper in drinking water is usually set at between 1.5 and 2 milligrams per liter. The maximum safe human daily intake is 10 milligrams.

The recommended daily allowance is 0.9 milligrams per day. By comparison, the equivalent human dose to that given in the animal study is 2.7 milligrams. This is still less than one-third the maximum safe daily intake of 10 milligrams.

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There’s new scrutiny of  statins, which are the most popular prescription drug ever that’s been marketed as a cholesterol-lowering medication.

As Businessweek reports: “The drugs are thought to be so essential that, according to the official government guidelines from the National Cholesterol Education Program, 40 million Americans should be taking them. Some researchers have even suggested-half-jokingly-that the medications should be put in the water supply, like fluoride for teeth.”

This week, CBS News partnered with Businessweek, which reported today that statins don’t necessarily help patients in the way they are thought to. Read our partner story from Businessweek here.

While it is possible that it is in your best interest to use cholesterol-lowering medication, medical experts suggest ways to lower your cholesterol without drugs - making simple lifestyle changes.

The American Heart Association’s Web gives simple recommendations in a checklist for lowering cholesterol. It suggests taking simple measures: exercising regularly, eating a heart-healthy diet and making certain lifestyle choices, such as avoiding tobacco smoking.

Eating healthy

The American Heart Association offers some information on cholesterol, your body and your diet.

Some of your cholesterol is made by your body. The food you eat is responsible for the rest. Food products from animals contain cholesterol - including meats, poultry, shellfish, eggs, butter, cheese and whole or 2 percent milk. And any type of food can also contain saturated fats and trans fats, which cause your body to make more cholesterol.

The American Heart Association recommends that you keep your intake of total fat to between 25 percent and 35 percent, your saturated fat consumption to less than 7 percent and your intake of trans fat to less than 1 percent of your total daily calories.

At the same time, limit your intake of cholesterol from food to less than 300 mg per day. People with high LDL (bad) blood cholesterol levels or who are taking cholesterol medication should consume less than 200 mg of cholesterol per day.

Eat at least 25 to 30 grams of dietary fiber each day - preferably from whole grains, fruits, vegetables and legumes. To combat high blood pressure and for overall cardiovascular health, also limit sodium to 2,300 mg or less per day.

But a heart-healthy diet isn’t just about what you shouldn’t eat. It also means eating a diet rich in vegetables and fruits, with whole grains, high-fiber foods, lean meats and poultry, fish at least twice a week, and fat-free or 1 percent fat dairy products. Also, the diet should be low in saturated fat, trans fat and cholesterol.

But can a bowl of cereal help prevent a heart attack? The Mayo Clinic suggests the best foods to lower your cholesterol and protect your heart. A partial list from the Mayo Clinic is below.

Oatmeal

Oatmeal contains soluble fiber, which reduces your “bad” cholesterol. Soluble fiber is also found in such foods as kidney beans, brussels sprouts, apples, pears, psyllium, barley and prunes.

Walnuts and almonds

Studies have shown that walnuts can significantly reduce blood cholesterol. Rich in polyunsaturated fatty acids, walnuts also help keep blood vessels healthy and elastic. Almonds appear to have a similar effect, resulting in a marked improvement within just four weeks.

Fish including omega-3 fatty acids

Studies in the 1970s showed that Greenland Eskimos had a lower rate of heart disease than did other individuals living in Greenland at the same time. Analysis of dietary differences between the groups showed that the Eskimos ate less saturated fat and more omega-3 fatty acids found in fish and whale and seal meat. Research since that time has supported the heart-healthy benefits of eating fish. If you can’t dine with the Eskimos, other good sources of omega-3 fatty acids include flaxseed, walnuts, canola oil and soybean oil.

Soy

Long thought to have cholesterol-lowering effects, a recent meta-analysis by the American Heart Association’s Nutrition Committee showed soy protein actually has very little impact on reducing cholesterol levels. In January 2006, the American Heart Association issued a statement saying the cardiovascular health benefits of soy protein are minimal at best. No benefit was seen on HDL, triglycerides, or blood pressure and even with a large intake of soy, only a small impact on LDL was seen.

Stay away from smoke

The American Heart Association advises the following:
Cigarette and tobacco smoke, high blood cholesterol, high blood pressure, physical inactivity, obesity and diabetes are the six major independent risk factors for coronary heart disease that you can modify or control. Cigarette smoking is so widespread and significant as a risk factor that the Surgeon General has called it “the leading preventable cause of disease and deaths in the United States.”

Cigarette smoking increases the risk of coronary heart disease by itself. When it acts with other factors, it greatly increases risk. Smoking increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot. Smoking also increases the risk of recurrent coronary heart disease after bypass surgery.

Keep up physical activity

Physical inactivity is a major risk factor for heart disease, according to The American Heart Association, which recommends getting at least 30 minutes of physical activity, preferably every day but at least more days than not.

You don’t need to get your minutes all at once - it’s fine to break up your activity into 10-minute sessions or 15-minute sessions. For some people, regular physical activity affects blood cholesterol level by increasing the level of HDL (good) cholesterol. A higher HDL level is linked with a lower risk of heart disease. Physical activity can also help control other risk factors for heart disease: weight, diabetes and high blood pressure. Aerobic exercise (exercise that uses oxygen to provide energy to large muscles) raises your heart and breathing rates, which help your heart to work more efficiently at rest as well as during physical activity. Vigorous, regular physical activity such as brisk walking, jogging and swimming also condition your lungs.

Even mild activities, if done daily, can help. You can benefit from simple things like walking, gardening, housework or dancing. Talk to your doctor about getting started, especially if you’ve been inactive.

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When a person’s cholesterol level rises too high, that fatty substance traveling around in the circulatory system can start to leave deposits on the inside walls of arteries. This is known as plaque. As it builds up, it gradually narrows down the internal space of that artery, making it harder for blood to flow through. This can cause strokes and heart attacks because so little blood eventually gets through that the heart or brain (depending on which artery is clogged) is deprived of oxygen and loses function.

This study ended about a year ago. It was done on two drugs, called Zetia and Vytorin, made by Merck and Schering-Plough respectively. They have been used by millions of people to lower cholesterol. In this two-year study, 720 patients in Europe, chosen because they have genes which cause high cholesterol levels, received one of two drugs:

* Zocor, an older cholesterol drug; or
* Vytorin, a combination of Zocor and Zetia.

It was thought that Vytorin would reduce plaque build-up more than would Zocor alone. But the results, recently released, show that in those patients taking Vytorin, plaque accumulated nearly twice as much as in those taking the older Zocor. The Vytorin did reduce cholesterol significantly more than Zocor alone; but it did not reduce plaque formation.

The issue being given media coverage is: why did the two companies take a year to release these disappointing results? A House committee will be set up to explore why.

But just as important, or more so, are other considerations, such as:

* This study was small, with only 720 patients, and therefore can’t be definitive
* Those 720 patients had taken unknown drugs for unknown periods of time before entering the study, which could have reduced the effectiveness of the Vytorin
* Is it correct to assume that lowering cholesterol will necessarily reduce or prevent plaque formation? Other factors may be contributing, such as genetics, which we know was the case with these 720 patients.

The two companies are running three more larger trials to test Vytorin’s effectiveness in reducing heart attacks and strokes. Those results won’t be available until 2011.

New drugs are developed, tested, sold, and recalled constantly. If you or a loved one have been harmed by a dangerous drug, please contact us for a free case evaluation.

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Kids overweight by age 2

One of Dublin’s busiest hospitals reports treating kids for weight problems as young as age 2 and says immediate action needs to be taken to stop childhood obesity. Doctors say they’re seeing more overweight kids and that people don’t understand that having a chunky child isn’t just a cosmetic issue that they’ll grow out of…

Does low cholesterol matter?

Following the report earlier this week that the cholesterol-lowering drug Zetia didn’t actually lower the amount of plaque in the body, some cardiologists are saying the idea that lowering cholesterol is the key to good heart health is too simplistic. Even though these drugs are the biggest sellers in the country, heart disease is still the leading killer, and drugs have been approved that lower cholesterol without proving that they also lower the number of heart attacks patients have. Reports that drugs lower cholesterol but don’t lower risk factors for heart attacks mean the two might not be as linked as some people think…

Starbucks takes organic milk off the menu

Starbucks has announced it will be eliminating organic milk from its shops next month because they are now using non-organic milk made without growth hormones. Starbucks says it offered organic milk at a higher price for those customers who said they wanted hormone-free milk, and now that all their milk is hormone free they no longer need to offer the option, since orders for organic milk have always been “very low”…

Modified carrot provides more calcium

Scientists at Baylor College of Medicine in Texas have developed a carrot that gives people more calcium than conventional carrots and could help ward off osteoporosis. The carrot allows for absorption of 41 percent more calcium than is retained from traditional carrots, and researchers say it could be helpful for those who don’t tolerate milk products to get more calcium. More research into the safety of the veggies is needed before they’ll hit the shelves…

Quiznos has released two small Sammies that are under 200 calories each. The $2 sandwiches are served on flatbread and the options are balsamic chicken and black angus. (Incidentally, Quiznos has finally revealed some nutritional information, so these lighter sandwiches might be a way of cleaning up their act.) But beware if you’re not ordering one of the lower-calorie sandwiches and you choose the meal deal, which includes two sandwiches, chips and a drink. Your calories will add up fast…

Use a laundromat? You must be fat

Finally, an interesting ad campaign has shown up in New York City laundromats this week. Tiny T-shirts found in dryers around the city suggest that the people who find them ought to “shrink a few sizes.” The campaign is being run by the Ad Council and the U.S. Department of Health and Human Services and directs people to the Small Step website. I wonder what gave them the idea that people who don’t have washers in their homes are fatter than people who do?

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Research suggests that, except among high-risk heart patients, the benefits of statins such as Lipitor are overstated Martin Winn’s cholesterol level was inching up. Cycling up hills, he felt chest pain that might have been angina. So he and his doctor decided he should be on a cholesterol-lowering medication called a statin. He was in good company. Such drugs are the best-selling medicines in history, used by more than 13 million Americans and an additional 12 million patients around the world, producing $27.8 billion in sales in 2006. Half of that went to Pfizer (PFE) for its leading statin, Lipitor. Statins certainly performed as they should for Winn, dropping his cholesterol level by 20%. “I assumed I’d get a longer life,” says the retired machinist in Vancouver, B.C., now 71. But here the story takes a twist. Winn’s doctor, James M. Wright, is no ordinary family physician. A professor at the University of British Columbia, he is also director of the government-funded Therapeutics Initiative, whose purpose is to pore over the data on particular drugs and figure out how well they work. Just as Winn started on his treatment, Wright’s team was analyzing evidence from years of trials with statins and not liking what it found.

Yes, Wright saw, the drugs can be life-saving in patients who already have suffered heart attacks, somewhat reducing the chances of a recurrence that could lead to an early death. But Wright had a surprise when he looked at the data for the majority of patients, like Winn, who don’t have heart disease. He found no benefit in people over the age of 65, no matter how much their cholesterol declines, and no benefit in women of any age. He did see a small reduction in the number of heart attacks for middle-aged men taking statins in clinical trials. But even for these men, there was no overall reduction in total deaths or illnesses requiring hospitalization—despite big reductions in “bad” cholesterol. “Most people are taking something with no chance of benefit and a risk of harm,” says Wright. Based on the evidence, and the fact that Winn didn’t actually have angina, Wright changed his mind about treating him with statins—and Winn, too, was persuaded. “Because there’s no apparent benefit,” he says, “I don’t take them anymore.”

Wait a minute. Americans are bombarded with the message from doctors, companies, and the media that high levels of bad cholesterol are the ticket to an early grave and must be brought down. Statins, the message continues, are the most potent weapons in that struggle. The drugs are thought to be so essential that, according to the official government guidelines from the National Cholesterol Education Program (NCEP), 40 million Americans should be taking them. Some researchers have even suggested—half-jokingly—that the medications should be put in the water supply, like fluoride for teeth. Statins are sold by Merck (MRK) (Mevacor and Zocor), AstraZeneca (AZN) (Crestor), and Bristol-Myers Squibb (BMY) (Pravachol) in addition to Pfizer. And it’s almost impossible to avoid reminders from the industry that the drugs are vital. A current TV and newspaper campaign by Pfizer, for instance, stars artificial heart inventor and Lipitor user Dr. Robert Jarvik. The printed ad proclaims that “Lipitor reduces the risk of heart attack by 36%…in patients with multiple risk factors for heart disease.”

So how can anyone question the benefits of such a drug?

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Bring ‘bad’ cholesterol down, regardless.
Q: I just read that if you have low LDL cholesterol, you have a higher risk of Parkinson’s disease. Does that mean you shouldn’t try to lower your LDL if you have a family history of Parkinson’s?

A: Parkinson’s disease is a neurological condition affecting the “substantia nigra,” a small area of cells in the midbrain. Degeneration of these cells results in lower levels of the neurotransmitter dopamine (a brain-signaling chemical) and upsets the balance between dopamine and another brain chemical, acetylcholine. The most familiar signs of the disease are resting tremors, a generalized slowness of movement, stiff limbs, and problems with balance or gait. Depression is also common. In advanced cases, mental function can deteriorate. Parkinson’s disease is progressive and incurable.

A small study from the University of North Carolina (UNC) at Chapel Hill suggests that people with low LDL (low-density lipoprotein, the “bad” cholesterol) are more likely to develop Parkinson’s than those whose LDL is high. (As far as your heart is concerned, low LDL is good — the lower it is, the lower your risk of heart disease.) The North Carolina researchers tested the cholesterol of 124 Parkinson’s patients being treated at the UNC Movement Disorder Clinic and 112 spouses of clinic patients. They found that those with LDL levels of less than 114 (mg per deciliter) had a 3.5 times higher incidence of Parkinson’s than study participants whose LDL was more than 138.

However, we don’t know whether the Parkinson’s patients’ LDL was low before the onset of the disease. The researchers did determine that study participants with Parkinson’s were less likely to have taken cholesterol-lowering drugs than those in the control group.

While these findings are interesting, the investigators described them as preliminary and called for larger studies to help clarify how LDL affects the risk of Parkinson’s.

In the meantime, if your LDL cholesterol is high, you should follow medical advice to bring it down. After all, it’s long been known that smoking is linked to a lower risk of Parkinson’s, but it’s certainly not a good idea to take up cigarettes to protect yourself from the disease. Keep the relative risks in mind: the incidence of Parkinson’s disease is 12 to 20 cases per 100,000 persons per year. The incidence of heart disease is 1 in 12.

Iodine therapy

Q: I just had my thyroid removed due to papillary cancer. I am told that radioactive iodine to destroy the tiny remnant of thyroid tissue remaining after surgery is recommended, that it’s “well tolerated” and has “no side effects.” My research (and intuition) tell me otherwise! What is your opinion?

A: As I’m sure you know by now, the type of thyroid cancer you had is very slow-growing and very rarely fatal, particularly in younger people. Radioactive iodine is used to destroy any thyroid tissue that wasn’t removed by surgery in order to be sure that all traces of cancer are eliminated. It is considered to be a safe procedure.

I discussed your case with Randy Horwitz, M.D., medical director of the Program in Integrative Medicine, and Merilyn Goldschmid, M.D., an endocrinologist; both are here at the University of Arizona. Both agreed that the use of radioactive iodine in cases such as yours is appropriate and carries low risk. Dr. Goldschmid advised a single dose of radioactive iodine and recommended that you drink plenty of fluids following your treatment to flush the iodine out of the salivary gland, the only gland beside the thyroid that can retain it. She and Dr. Horwitz also cautioned that women need to use contraception for about a year after the treatment, because radioactive iodine can affect the ovaries. Women’s periods can become irregular for a while but should return to normal at the end of a year.

Side effects of radioactive iodine treatment are rare, but occasionally patients do experience some neck tenderness, nausea and stomach irritation, dry mouth and tenderness of the salivary glands (sucking on lemon drops can reduce this). There is a very small risk of developing leukemia in the future. In my view, the risk of the iodine treatment is much lower than that of leaving a bit of cancer behind following thyroid surgery. Therefore, I suggest that you follow your physician’s recommendations and have the treatment. I know of no alternative that would serve you as well.

The views expressed in this column are the author’s. Readers are advised always to consult their doctor for specific information on personal health matters. The naming of any product or therapy in this column does not represent an endorsement by The Vancouver Sun.

Ask Dr. Weil does not provide specific medical advice and is not intended as a substitute for the advice provided by your physician or other health-care professional. You should always consult your physician to discuss specific symptoms and conditions.

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The enzyme HMG-CoA reductase (HMGR) catalyzes the rate-limiting step in cholesterol biosynthesis. HMGR has been closely studied and hotly targeted by pharmaceutical designers; it is famously the target of the family of cholesterol-lowering drugs known collectively as statins — one of which, Pfizer’s flagship Lipitor, is the top-selling prescription medication in the world.

Elevated HMGR can cause hyperlipidemia, which is co-morbid with a host of late-life disease including atherosclerosis, stroke and even cancer. It is therefore discouraging to learn that HMGR levels increase during aging — this may explain why hypercholesterolemia, although under significant genetic influence and therefore latent in an individual throughout the lifespan, takes a few decades to manifest itself. In a rat liver model, the rise in activity appears to occur in response to high levels of reactive oxygen species (ROS); a new paper by Pallattini et al. describe the regulatory biology of this phenomenon and argue that the ROS effect on HMGR activity is mediated via the p38/MAPK pathway.

This suggests the benefits of antioxidant therapy in conjunction with HMGR inhibition — but why take two pills when you can take only one? Ajith et al. report that the compound rosuvastatin (AstraZeneca’s Crestor) is both a potent HMGR inhibitor and an antioxidant. The antioxidant activity is narrow-spectrum, apparently specific for hydroxyl radicals but with no effect on superoxide; nonethless, it significantly protects against oxygen-induced DNA damage as well as lipid peroxidation.

I’d be very interested to know whether rosuvastatin’s antioxidant action inhibits the age-related increases in HMGR levels in the rat liver model studied in the Pallatini paper. If so, compounds of this kind could provide a potent “one-two punch” against late-life hyperlipidemia and its associated diseases.

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Without the right kinds of cholesterol, your body could have problems tackling many tasks, including digesting certain foods.

Take a look at these quick facts to make sure you’re on the good side of the cholesterol battle.

1. Stay in shape.
“Exercise is the best thing you can do,” said Dr. Cynthia Williams, St. Francis Hospital & Health Centers. “Walking is great, but it’s got to be 30 minutes of continuous walking.” The key here is making sure anything you do is aerobic exercise, Williams said. She also points out that someone who says they walk all day at work might not actually be exercising.

2. Know the numbers.
When you’re tracking your cholesterol levels, LDL is something you don’t want to see a lot of, said Amanda Scott, a health educator with Health & Nutrition Technology in Carmel. “This is the cholesterol that carries fatty buildups to your heart and artery walls,” she said. The best way to fix this is to watch your diet. Better eating will help reduce your weight, taking some of the LDL with it. The goal is to get the LDL number under 130 for most people, or under 100 if you have diabetes, Scott said.

3. Shop right.
At the grocery, take time to find the right foods. “Cholesterol is found in animal products only,” Scott said. “Limiting high-fat animal products helps. And try a low-fat or skim milk.” Other items to consider are soluble fiber products, including oats, beans, peas, bran, barley, citrus, strawberries, apple, Brussels sprouts, broccoli and carrots. These reduce LDL by attaching to cholesterol and being excreted through the bowels.

4. Mind your medicine.
Medical experts stress the importance of healthy living and good eating as key factors in the cholesterol battle. But both take time and might not be an option for some patients. “If someone’s had a heart attack, I may not give them the time to exercise to lower cholesterol,” Williams said. “I’ll be more aggressive.” Usually, that’s the key indicator for when medicine will be used to treat cholesterol issues. At the same time, some medicines can have negative effects of their own, so get all of your questions answered before moving forward.

5. Check it out.
Keeping an eye on your cholesterol levels isn’t a full-time job. A simple blood test is all it takes, and that typically needs to be done just once every five years if you have a clean bill of health. Williams and Scott agreed that when patients have diabetes or heart ailments, it’s a good idea to increase the frequency to every year or two.

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Researchers have discovered seven new genes that affect cholesterol levels in humans and that may influence the risk of heart disease.

The research, conducted by scientists at Harvard, the University of Michigan, and the University of North Carolina, may be used in the future to help develop specifically targeted cholesterol medications.

“We could potentially figure out the most appropriate medication for each person, because it might not be the same for everyone,” said senior author of the study and professor at the University of Michigan, Goncalo R. Abecasis. He said there is potential to use the genes to build a specific genetic lipid profile for each person.

The study, published this week in Nature Genetics, also verified the role of 11 previously discovered genes that work to modify cholesterol levels.

The researchers identified 18 regions of the genome that account for about 25 percent of the variance in blood cholesterol levels, according to Abecasis.

Because most illnesses aren’t caused by a single gene, research today often focuses on discovering the genes that, when aggregated in an individual, contribute to disease, according to Mason W. Freeman ’73, professor at Harvard Medical School and chief of the Lipid Metabolism Unit at Massachusetts General Hospital.

“This begins to explain why people can have the same diet and exercise patterns and have different cholesterol numbers,” he said.

Increased levels of cholesterol, a lipid found in cell membranes, have been shown to promote hardening of the arteries, which can lead to cardiovascular disease.

There are two main types of cholesterol: LDL, the “bad” cholesterol, and HDL, the “good” cholesterol.

LDL has been shown to increase the risk of heart attacks and strokes, and is the type of cholesterol that has been successfully treated with pharmaceuticals. HDL has long been considered a protective factor, lowering the chances of heart disease.

The study found that only the genetic changes that are associated with LDL cholesterol influence the risk of heart disease.

“We know that LDL is causal to the buildup of fatty plaques in the heart arteries, but it now looks like simple blood measurements of HDL may not be causal,” said study author Sekar Kathiresan, an instructor in medicine at the Medical School and director of preventive cardiology at Massachusetts General Hospital Instead, the proposed protective qualities of high HDL may vary for each person.

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Adding Lipitor Early to Effective Blood Pressure Treatment Provided a Significant Reduction in Heart Attacks or Deaths from Heart Attacks over Five Years!

The early addition of Lipitor® (atorvastatin calcium) Tablets to effective blood pressure lowering treatment maintained a significant 36 percent reduction in the relative risk of fatal or non-fatal heart attacks over five years, according to a new analysis.

This was a post-hoc analysis (designed and completed following the closure of the trial) of the lipid-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-LLA) follow-up period. A majority of patients who were treated with Lipitor or placebo during a three-year study went on to receive Lipitor during two years of post-study follow up.

At the start of the study, patients had high blood pressure and additional cardiovascular risk factors but no coronary heart disease. ASCOT-LLA is one of the first studies to explore the benefit of controlling more than one cardiovascular risk factor at a time.

These important results show that early initiation of Lipitor with an effective blood pressure lowering drug regimen may have significant clinical implications for reducing the risk of heart attacks, said Professor Peter Sever, study principal investigator, professor of clinical pharmacology and therapeutics, International Centre for Circulatory Health at London’s Imperial College. It is vital that physicians use the right combination of treatments from the start to maximize the reduction in the risk of heart attacks and coronary heart disease death.

The results were published online in the European Heart Journal.

Patients with high blood pressure and other risk factors for cardiovascular disease are usually treated with blood pressure lowering medications first, said Professor Bryan Williams, professor of medicine, University Hospitals NHS Trust, Leicester, United Kingdom, and chairman of the British Hypertension Society Guidelines working party.

It is important to note, however, that many people with high blood pressure are also at sufficient risk of cardiovascular disease to benefit from statin therapy, he said. Even if patients are prescribed statins in this context, they are generally only treated with statins after lifestyle modifications have failed.

This study highlights the importance of initiating medical treatment for both blood pressure and cholesterol as soon as possible, and raises questions about medical guidelines that do not focus on early intensive treatment of multiple risk factors, notably blood pressure and cholesterol, in patients with moderate cardiac risk, he said.

Pfizer offers physicians and patients the option of Lipitor.

About the study

The ASCOT study was one of the largest hypertension trials ever conducted with 19,342 patients in Europe. It compared the calcium channel blocker anti-hypertensive Norvasc based regimen versus a beta-blocker based regimen in reducing cardiac events in patients with high blood pressure and additional cardiovascular risk factors but without coronary heart disease.

Patients in ASCOT-LLA had normal to mildly elevated cholesterol levels (n=10,000), were not candidates for lipid-lowering treatment at the time of the study initiation, and received Lipitor 10 mg or placebo at the outset of the trial.

The ASCOT-LLA part of the trial was expected to last five years, but was stopped early after three years due to a highly significant 36 percent lower risk of death from heart disease and non-fatal heart attack in patients treated with Lipitor versus patients taking placebo.

At the end of the follow-up period, LDL-C levels were similar in both groups as a result of Lipitor treatment and the average blood pressure level was significantly reduced from 164/95 mmHg to 137/78 mmHg with the blood pressure lowering therapy.

Funded by Pfizer, ASCOT was an investigator-led trial coordinated by an independent steering committee.

Important U.S. Prescribing Information for Lipitor

Lipitor is a prescription medication. It is used in patients with multiple risk factors for heart disease such as family history, high blood pressure, age, low HDL (?good? cholesterol) or smoking to reduce the risk of a heart attack and stroke, certain kinds of heart surgery and chest pain.

Lipitor is also used in patients with type 2 diabetes and at least one other risk factor for heart disease such as high blood pressure, smoking or complications of diabetes, including eye disease and protein in urine, to reduce the risk of heart attack and stroke.

Lipitor is used in patients with existing coronary heart disease to reduce the risk of heart attack, stroke, certain kinds of heart surgery, hospitalization for heart failure, and chest pain.

When diet and exercise alone are not enough, Lipitor is used along with a low-fat diet and exercise to lower cholesterol.

Lipitor is not for everyone. It is not for those with liver problems. And it is not for women who are nursing, pregnant or may become pregnant.

Patients taking Lipitor should tell their doctors if they feel any new muscle pain or weakness. This could be a sign of rare but serious muscle side effects. Patients should tell their doctors about all medications they take. This may help avoid serious drug interactions. Doctors should do blood tests to check liver function before and during treatment and may adjust the dose. The most common side effects are gas, constipation, stomach pain and heartburn. They tend to be mild and often go away.

Lipitor is used along with diet and exercise to lower high cholesterol. It is also used to lower the risk of heart attack and stroke in people with multiple risk factors for heart disease such as family history, high blood pressure, age, low HDL-C, or smoking.

Tell your doctor about all of the medicines you take. This may help avoid serious drug interactions. Your doctor should do blood tests to check your liver function before and during treatment and may adjust your dose. If you have any heart problems, be sure to tell your doctor. The most common side effects are edema, headache, and dizziness. They tend to be mild and often go away.

Lipitor is one of many options for treating high blood pressure and high cholesterol, in addition to diet and exercise, that you or your doctor can consider.

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