Cholesterol

I enjoyed a conversation with a health care professional today who is in her mid twenties, my guess. I was telling her about my recent revision of a stuffed cabbage recipe, soon to be on You tube, and she began to tell me about her parents and then herself.

She recalled that her father had been diagnosed with a severe artery blockage after failing a stress test. In fact, the stress test was so bad that he had surgery the next day. He was not yet 50 years old. His daughter remembers the day she came home from school to find her mother going through all the cabinets and removing foods that they couldn't eat any more. It was a little funny in the telling, as her mom didn't wean anyone off of anything. They went from whole milk to skim milk in a matter of minutes. Her mom also learned to cook differently and not badly. Her dad has been doing well, but on medicine for high cholesterol.

My friend learned a lesson from her parents and I am happy to see that her parents took the situation seriously. I have known too many who deny that food has any role in disease and continue the same habits as before their diagnosis or heart attack. Her mother acted seriously, quickly and permanently.

The second part of the story does not fit into my perfect world - magical thinking however. My friend was diagnosed with high cholesterol herself, familial high cholesterol, and started on medication at the age of 16. She was already active, but even being young and active and eating well, her cholesterol was over 300. On medication it is 180. At 16 her HDL was 20. When she told me how low it was, I gasped. BTW, she is also thin. I am concerned because statins do have side effects and I can't imagine that they were ever intended to be used in the teen age population.

The main concerns with statins, such as Lipitor, are muscle pain and sometimes a deadly condition of muscle wasting, kidney and liver failure are also listed as adverse event risks as is pain in the extremities,but believe it or not, these conditions are very rare. I did some research before posting this blog, and did not find what I expected. Of course, I went to academic journals and Medscape to do my reading, other websites, such as those that sell alternative meds to treat high cholesterol did talk a lot about kidney failure from the muscle wasting condition, which is called rhabdomyolysis. I found a study that followed children (214) aged 8 to 18 who were given statins for two years and no real problems were discovered.

My friend wants to try a different course of treatment but when she came off her meds before the cholesterol went right back up. You always have to weigh the risk, in this case, usually muscle pain, but more seriously rhabdomyolysis, to the benefit of not having a heart attack and dying.

After the statin Baycol was pulled from the market because of some kidney failure deaths, a safety task force did review pre and post market drug studies and concluded that the remaining statin meds were not high risk at all. The National Lipid Association was responsible for the task force and the final recommendations.

My last thought is this. The first statin to come on the market with FDA approval did so in 1987. That is only 22 years ago. We have no where near the long term data to say that the body can safely metabolize those drugs for 40 to 60 years, which is what you are looking at if you prescribe them to children! But what do we do for people whose condition does not respond to lifestyle changes if we don't use the medicine?