Beyond cholesterol

Heart disease is our leading cause of death and almost 20 million Americans take cholesterol pills. Recent evidence shows there is even more that can be done. Surprisingly, almost 50 percent of strokes and heart attacks occur in folks without high cholesterol!

A large group of healthy middle-aged volunteers were tested by CAT scan for calcium build up in the coronary arteries and this was compared with hours of sleep. There was a 27 percent chance of heart disease in those who slept five or less hours a night and only 6 percent in those who slept more than six hours. This means the risk of having blocked coronary arteries can be over four-times less if you get enough sleep.

Also quite interesting is that a strong connection has been found between low levels of vitamin D and coronary disease. Those people with very low levels are twice as likely to have a heart attack, and we know low vitamin D levels are related to living in a Northern climate such as upstate New York where we have less sunlight. Vitamin D can help lower blood pressure as well as blood sugar and the higher recommended dose for daily supplement is 1,000 IU.

The most interesting new development is research involving 18,000 individuals in 26 countries who were given a cholesterol drug called Crestor even though they had no signs of heart disease or elevated cholesterol levels. What they did have was elevated level of a blood test for inflammation called high sensitivity CRP.

The average age for both men and women was about 66 and repeat testing within two years showed LDL (bad cholesterol) was lowered 50 percent and the CRP was lowered by 37 percent. The risk of stroke or heart attack was reduced 50 percent in the group taking cholesterol-lowering medication. The remarkable extra benefit was attributed directly to reducing coronary artery inflammation as measured by the CRP test.

I order this very inexpensive test frequently in my practice, particularly in patients who have cardiovascular risk factors such as diabetes, smoking or family history. The bottom line is that those individuals who took the statin drug even with normal cholesterol to begin with but with an elevated CRP test had 50 percent reduction in stroke and heart attack. The risks of taking a drug like Crestor include muscle pain and memory loss.

Happy New Year and stay well.

Dr. Josh Schwartzberg has practices in Willsboro and Lake Placid. He can be contacted at 877-DOC-JOSH.

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