Cholesterol-lowering Higher harm than good

Experts discuss the use of cholesterol-lowering statins

08/21/2014

Nearly every third adult in this country has too much cholesterol in their blood, a natural substance that only occurs in animal foods such as chicken eggs, offal or butter. An elevated cholesterol level, however, is not safe for health, because it can lead to diseases of the vessels, with possible consequences such as a heart attack or stroke. In order to lower the level, weight loss and exercise are important in addition to a conscious, low-cholesterol diet. In addition, cholesterol-lowering drugs are often used, the benefits of which are controversial among European cardiovascular specialists.

More than half of adults have too much cholesterol in their blood
An elevated cholesterol level is not a rare phenomenon; instead, more than half of adults in this country are affected. Cholesterol is not a per se „dangerous“ Substance, instead, is a fat-like substance that is essential to life, as it is involved, for example, in the construction of the cell membrane and in many metabolic processes of the brain. The amount of cholesterol that is needed daily is mostly produced by the body itself (especially in the liver), the rest is taken from animal food, with chicken eggs, offal, butter and lard especially high in cholesterol. Accordingly, the daily intake of cholesterol should not be overlooked, as experts today recommend consuming no more than 250 to 300 mg of additional cholesterol per day. The reason: Too high a cholesterol level is a health risk factor for diseases of the vessels, with possible consequences such as a heart attack or stroke.

Lower cholesterol through diet change and more exercise
If the blood cholesterol level is too high, there are a number of measures that sufferers should take to reduce it. Central here is above all a conscious, low-cholesterol diet as well as regular exercise and the reduction of obesity. In addition, it is always sensible for the heart health to quit smoking. In many cases, those affected will also be receiving medication („statins“) - but here it comes again and again among experts to controversy, in which cases this is actually effective. In this context, a new treatment recommendations published by US medical societies at the end of 2013 mainly led to discussions among European cardiovascular specialists: „The recommendations of the US guidelines mean that many more people have to be assigned to a risk group and have to be given preventive treatment with statins, "says internist Nikolaus Marx from the German Cardiac Society (DGK) to the news agency „dpa“.

Value settles „good“ and „bad“ Cholesterol together
This would get „the statin therapy [...] a very high weight“, explains the doctor on - but much to the chagrin of many critics. Because cholesterol is not equal to cholesterol in the blood, instead the value is composed of different components: the so-called „HDL cholesterol“ It is considered "good" cholesterol because it protects the vessels, while the "bad" LDL cholesterol favors arteriosclerosis and thus cardiovascular disease. An assessment of whether the blood cholesterol level actually represents a health risk, could therefore bring a look at the total cholesterol level: If this is higher than 200 milligrams per deciliter (mg / dl), it would be useful, the LDL and To measure HDL levels. But according to Marx, that's not all, because not only is cholesterol interesting to assess a health hazard, but also other risk factors: „In addition to the cholesterol values, factors such as high blood pressure, diabetes, age, gender and a possible familial predisposition must be taken into account in the assessment.“

Despite taking medication, lifestyle needs to be changed
If there is an increased risk as a result of the examinations, cholesterol-lowering medications are usually used - whereby the formula usually applies: the higher the overall risk, the more effective the medicines. Nevertheless, statins do not provide any „panacea“ and do not replace the change in diet and lifestyle habits. Rather, sufferers must be very mindful despite the intake, especially when eating fats, since „a diet that is low in saturated fat can lower the risk of cardiovascular disease“, The Institute for Quality and Efficiency in Health Care (IQWiG) reports to the „dpa“. This does not necessarily mean a generally low-fat diet, „It is more important to replace saturated fats with unsaturated ones, if possible - ie to eat more plant-based foods and fish than meat and high-fat dairy products. "

Statins can cause muscle aches and diabetes
If medicines have to be used anyway, the gold standard is the gift of „statins“, which intervene in the lipid metabolism and thereby stop the production of cholesterol. While using in cardiovascular patients („secondary prevention“) is considered largely uncritical, the drug treatment actually healthy for the prevention of heart attack and stroke, however, always leads to discussions. Because in this case it always comes back to muscle problems, also seems to be elevated with regular intake of statins and the risk of diabetes. However, according to the report of a US research group led by Jacek Kubica in the "American Journal of Cardiology", this depends on the dosage and the exact nature of the drug - so much more attention may need to be paid in the future to keep the medication as low as possible. „Recent studies show that statins are associated with an increased risk of developing new diabetes mellitus (DM) compared to placebo, and that this ratio is dose-dependent. [...] In conclusion, different types and dosages of statins have different potential to promote the onset of diabetes“, so the researchers in their article. (No)