Millions of Americans take statins to lower their cholesterol, but how low should you go" Many scientific studies support the benefits of lowering low-density lipoprotein (LDL) cholesterol, and achieving low LDL cholesterol levels is one of the most important steps in preventing heart disease. New research, however, provides evidence for an association between low LDL levels and cancer risk.
The authors of the study, published in the July 31, 2007, issue of the Journal of the American College of Cardiology (JACC), set out to understand how and why statins cause side effects, particularly damage to the liver and muscle cells. The study findings support taking multiple medications rather than high-dose statins to minimize those side effects. The researchers did not expect to find the increased cancer risk (one additional incident per 1,000 patients) from low LDL levels, and additional studies have already begun to investigate this potential risk further. A key component in future studies will be to confirm the risk and to identify whether the risk may be a side effect of statins or just low LDL.
“This analysis doesn’t implicate the statin in increasing the risk of cancer,” said lead author Richard H. Karas, M.D., F.A.C.C., professor of medicine at Tufts University School of Medicine. “The demonstrated benefits of statins in lowering the risk of heart disease remain clear; however, certain aspects of lowering LDL with statins remain controversial and merit further research.”
The researchers found one additional incident of cancer per 1,000 patients with low LDL levels when compared to patients with higher LDL levels. In their evaluation of randomized controlled statin trials published before November 2005, the researchers looked at 13 treatment arms consisting of 41,173 patients.
Researchers assessed absolute change and percentage of change in LDL reduction and the resulting achieved LDL levels in relation to rates of newly diagnosed cancer in each treatment arm. They also looked at the relationship between low, intermediate and high doses of statins and rates of newly diagnosed cancer. Although they did not find a relationship between percent of change and absolute change in LDL levels, they observed higher rates of newly diagnosed cancer among patients with lower achieved LDL levels. In addition, the new cancers were not of any specific type or location.
Recent data from large-scale statin trials have shown that more intensive LDL lowering can provide significant cardiovascular benefits to higher-risk patients. In response to these findings, recent national guidelines have advocated for lower LDL goals and higher doses of statins to reach them. However, informal observations linking intensive LDL lowering and higher incidence of reported health problems, including liver and muscle toxicity and cancer, has introduced some concern over the safety of such treatments.
These concerns in part prompted the current study. However, the current findings are not definitive, as limitations of the study show. Researchers performed their analysis from summary data taken directly from published manuscripts of each trial. An analysis based on data for each individual patient would have yielded more specific and potentially more compelling results, said Dr. Karas.
“These current findings provide insufficient evidence that there is any problem with LDL lowering that outweighs its significant benefits on vascular disease,” said John C. La Rosa, M.D., who wrote an accompanying editorial in the July 31 issue of JACC. However, “we must continue to be vigilant in ensuring that its benefit clearly outweighs its risk.”
Although the cancer risk was surprising, the researchers primarily sought to determine how and why statins cause side effects, particularly damage to the liver and muscle cells. For this portion of the study, researchers analyzed 23 statin treatment arms that included 75,317 patients with a combined 309,506 years of follow up. A link between LDL lowering and liver or muscle irritation was not found. However, liver toxicity levels increased with higher statin dosage. Based on their findings, the researchers concluded that moderate-dose therapy with multiple medications including statins may prove to be preferable to high-dose therapy with statins alone. Dr. Karas emphasized that patients are advised to continue their statin treatments and, as always, consult their doctor before discontinuing use of any medication.
“While these results raise important new questions about statin use, they do not demonstrate a causal relationship between statins and cancer,” said James Dove, M.D., F.A.C.C., president of the American College of Cardiology. “This study is hypothesis-generating, not hypothesis-proving.”
Amy Murphy | EurekAlert!
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Scientists reveal source of human heartbeat in 3-D
07.08.2017 | University of Manchester
Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.
As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...
Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.
Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...
For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.
While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...
An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.
The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...
A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.
Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...
16.08.2017 | Event News
04.08.2017 | Event News
26.07.2017 | Event News
17.08.2017 | Physics and Astronomy
17.08.2017 | Earth Sciences
17.08.2017 | Physics and Astronomy