2015-09-09 / Health

For high cholesterol, statins are way to go

DEAR DR. ROACH: Last year, I told my doctor that I no longer wanted to take a statin drug. I had read so much about statins and am on meds for cholesterol and high blood pressure. I am 73, and other than having arthritis in my knees, I am not having problems.

My doctor put me on fenofibrate. I am due for my yearly checkup in a few months and don’t really know yet how this is working on my cholesterol. I was wondering what your feelings are about this drug. — RS

ANSWER: I’ve written a lot about statins, which have been proven to save lives and reduce heart attacks in people with heart disease and also in some people at higher-than-average risk for heart disease. In contrast, although non-statin medications reduce cholesterol, they have not been proven to do what they are really intended to do, which is to prevent heart disease and death.

I suspect that medications like fenofibrate do have a small benefit in protecting the heart; however, I would not use them unless the side effects of statins made it impossible to take one. Often, people intolerant of one statin do well on another. For people at high risk, such as those with previous heart attack or known blockages, I would try a different class of medication. For people at lower risk, I would work on a diet proven to reduce heart disease risk, such as the Mediterranean diet, and encourage regular exercise and use medications such as fenofibrate sparingly or not at all.

Another medication, ezitimibe (Zetia or Ezetrol), also lowers cholesterol but without convincing proof that it lowers heart disease risk. It may be that the mechanism by which statins reduce heart risk is not just through lowering cholesterol.

Learn more about high cholesterol and how to control it in the cholesterol booklet. Readers can order a copy by writing: Dr. Roach — No. 201W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.

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DEAR DR. ROACH: I am 81 years old and in good health. I am 5 feet, 11 inches tall and weigh 168 pounds, the same as in 1950. My blood pressure and cholesterol are good on treatment, and my pulse is 62. I drink an energy drink three or four times a week after the noon meal, when I don’t take a nap and need to keep going. I am a farmer, and am active every day. Are these energy drinks harmful to me? — L.M.W.

ANSWER: The caffeine in one energy drink is about 160 mg per 16-ounce can, which is the equivalent of somewhere around a cup or two of regular coffee, depending on how strong you make it. That much caffeine doesn’t cause problems for most people, especially for those who are used to it. However, it also has 52 grams of sugar — about 14 teaspoons. My advice is to stick with coffee. You will save money and reduce your sugar intake a lot.

Readers may emai l questions to ToYourGood- Health@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive Orlando, FL 32803.

©2015 North America Synd.

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