Statin Drugs

What are the statin drugs?

The statins are the most widely used, and also the most powerful medications for lowering LDL cholesterol. Numerous large, randomized, double-blind, placebocontrolled, , clinical trials controlled trials) have shown that statins reduce heart attacks (and strokes) and improve survival. Statins are well tolerated with low side effect rates when used long term. Statins not only lower blood LDL cholesterol levels, they also modestly increase HDL cholesterol levels and
modestly decrease triglyceride levels. The statins that are now on pharmacy shelves in the U.S. (putting the generic name first followed by the brand name in
parentheses) are:

• rosuvastatin ( Crestor)
• fluvastatin sodium (Lescol) made by Novartis
• atorvastatin calcium (Lipitor) made by Parke-Davis and Pfizer
• lovastatin (Mevacor) made by Merck
• pravastatin sodium (Pravachol) made by Bristol-Myers Squibb
• simvastatin (Zocor) made by Merck

Studies have consistently shown that lowering LDL cholesterol with diet and statins reduces the risk of a second heart attack. The prevention of recurrent heart attacks in patients who have already suffered a heart attack is called secondary prevention.

Studies have also demonstrated that reducing LDL cholesterol with lifestyle changes and statins reduces the risk of having the first heart attack. Prevention of heart attacks in those who have never had a heart attack is called primary prevention.

Studies have also confirmed that reducing LDL cholesterol benefits both men and women, and the elderly. For more, please read our article on Statins.

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How do doctors select statin drugs?

Which statin to use is an individualized decision. There are several considerations in choosing a statin:
? In patients who need intense LDL cholesterol-lowering, it is more appropriate to use one of the more potent statins, such as atorvastatin (Lipitor) or rosuvastatin (Crestor). Sometimes a statin may need to be combined with another medication such as cholestyramine (Questran), ezetimibe (Zetia) or nicotinic acid, in order to achieve the LDL cholesterol goals.

? In patients with chronic liver disease who need statin treatment, it is important to completely abstain from alcohol and use either pravastatin (Pravachol) or rosuvastatin (Crestor) in low doses. (Pravastatin and rosuvastatin are safer to use in patients with liver disease.) If LDL cholesterol goals cannot be attained with low doses of either of these two statins, cholestyramine Questran) or ezetimibe (Zetia) can be added.

? In patients who develop muscle aches or muscle damage with a statin, it may be appropriate to try another statin, such as pravastatin (Pravachol), that probably has less of a muscle toxic effect than the other statins. In patients who are at risk of developing muscle injury (for example a patient who is already taking gemfibrozil), pravastatin (Pravachol) would also be a suitable statin to use.
? Atorvastatin (Lipitor) and fluvastatin (Lescol) do not require dose adjustments in patients with kidney diseases.

What determines the level of LDL cholesterol in the blood?

The liver not only manufactures and secretes LDL cholesterol into the blood; it also removes LDL cholesterol from the blood. A high number of active LDL receptors on the liver surfaces is associated with the rapid removal of LDL cholesterol from the blood and low blood LDL cholesterol levels. A deficiency of LDL receptors is associated with high LDL cholesterol blood levels.

Both heredity and diet have a significant influence on a person's LDL, HDL and total cholesterol levels. For example, familial hypercholesterolemia (FH) is a common inherited disorder whose victims have a diminished number or nonexistent LDL receptors on the surface of liver cells. People with this disorder also tend to develop atherosclerosis and heart attacks during early adulthood.

Diets that are high in saturated fats and cholesterol raise the levels of LDL cholesterol in the blood. Fats are classified as saturated or unsaturated (according to their chemical structure). Saturated fats are derived primarily from meat and dairy products and can raise blood cholesterol levels. Some vegetable oils made from coconut, palm, and cocoa are also high in saturated fats.

What are LDL and HDL cholesterol?

LDL cholesterol is called "bad" cholesterol, because elevated levels of LDL cholesterol are associated with an increased risk of coronary heart disease. LDL lipoprotein deposits cholesterol on the artery walls, causing the formation of a hard, thick substance called cholesterol plaque. Over time, cholesterol plaque causes thickening of the artery walls and narrowing of the arteries, a process called atherosclerosis.

HDL cholesterol is called the "good cholesterol" because HDL cholesterol particles prevent atherosclerosis by extracting cholesterol from the artery walls and disposing of them through the liver. Thus, high levels of LDL cholesterol and low levels of HDL cholesterol (high LDL/HDL ratios) are risk factors for atherosclerosis, while low levels of LDL cholesterol and high level of HDL cholesterol (low LDL/HDL ratios) are desirable.

Total cholesterol is the sum of LDL (low density) cholesterol, HDL (high density) cholesterol, VLDL (very low density) cholesterol, and IDL (intermediate density) cholesterol.

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5 TIPS TO LIMIT YOUR CELL PHONE RISK

Director Devra Davis of the University of Pittsburgh's Center for Environmental Oncology, and her group recently put out recommendations that we should be using a speaker-phone or ear piece. The report says children, who have thinner skulls and developing brains, should use cell phones only in case of emergency. And heaven forbid anyone should carry a cell phone in a pocket or clipped to a belt.  "You're just roasting your bone marrow," Davis said.  Oh, boy. Another thing to worry about. Or maybe Davis is an alarmist. It's so hard to tell. Although there are many large studies showing no connection between mobile phones and cancer, there are a few that do.  As Davis puts it, do you really want to play Russian roulette with your head?  But if you do buy the cellphones-cause-cancer argument, you have to figure out the best way to talk on a cell phone, seeing as how most of us can't live without them. Should you use the wired headset that came with your phone? A Bluetooth earpiece?  Cell phones have been wildly popular for only a matter of years, and it can take at least a decade for cancers to show up. Studies contradict each other, and scientists bicker: Some will tell you with great conviction that there's nothing to worry about. Others will tell you with equal conviction that an epidemic of brain tumors may be just around the corner.  The cell phone industry itself says "the overwhelming majority of studies that have been published in scientific journals around the globe show that wireless phones do not pose a health risk."  So what are we all to do until they figure it out? After enough interviews with physicists, engineers and doctors to make me want to stick my head in a microwave oven, one common line of reasoning emerged. Cell phones do emit radiation. No one knows definitively whether it's enough to worry about. Mobile phones meet federal safety limits, but if you're still worried, there are some simple steps you can take to lower your exposure to radiation. 1. Use the speakerphone  This was, without question, the favorite alternative of the experts I talked to. Nothing is near your head. "Hold it away from a minimum of a few inches. A foot or two is ideal," said Magda Havas, an associate professor with the Institute for Health Studies at Trent University in Ontario, Canada.  Havas gives me a little math lesson. Every inch you can get away from your body, the radiation reduces very quickly. "Hold it out two inches, and the radiation drops by a factor of four. Hold it out four inches, and it drops by a factor of 16," she says. In other words, said Louis Slesin, editor of Microwave News, "every millimeter counts." 2. Use a wired headset with a ferrite bead No, this is not a piece of jewelry. A ferrite bead is a clip you put on the wire of a headset. The concern is that the wire itself emits radiation into your ear. The bead is designed to absorb the radiation so you don't. They're inexpensive and available at stores or online.  These clips are a favorite of Slesin's. "It's the way to go," he said.  Another fan: Lawrie Challis, physicist and former chair of the Mobile Telecommunications and Health Research Program, a government panel in Britain. "They did tests at the University of York and found that under even the worst conditions, if you use a ferrite bead, you can't even measure the radiation coming off the wire. This common device kills the radiation." Of course, if the phone is in your pocket or clipped to your belt, all bets are off, because the phone itself will be radiating into your body. So if you're worried about radiation, keep the phone as far away as possible, and Challis adds to do your best to make sure the wire isn't touching your body. 3. Use a Bluetooth earpiece  A Bluetooth earpiece still has radiation, but it's at least 100 times less than the radiation you get when you hold a cell phone to your head, Havas says. Our experts were split on which was better: a Bluetooth headset or a wired one. Israeli government recommendations issued this week specifically suggest a wire; Havas likes the Bluetooth. But even she says not to wear it when you're not talking; it still sends out a signal.  "Bluetooth is only whispering radiation into your ear. The problem is, some people wear it all the time," she says. "At the very least, switch it from ear to ear so you don't have too much exposure on one side."  Michael Foley, Ph.D., executive director of the Bluetooth Special Interest Group, says Bluetooth earpieces radiate 200 times less energy than cell phones.. "There is no evidence that a Bluetooth headset has any adverse effects on its users," he said. 4. Use a "hollow tube" earpiece It's just like a regular wired earpiece, except the last six inches or so -- the part next to your ear -- is a hollow tube. There's no wire under the plastic.  "You're getting the sound through the air. You're not dependent on radiofrequency waves," said Dr. David Carpenter, director of the Institute for Health and the Environment at the University of Albany.  Hollow tube earpieces can be purchased on several Web sites. 5. Get a phone with less radiation Phone radiation is measured in specific absorption rate, or SAR. To look up the SAR for your phone, check this list on CNET.com.  You might think the experts mentioned above all use earpieces or a speakerphone. Not so. Several said they hold it right up to their heads because they use their cells so infrequently, they're not worried about radiation.  "I use it maybe once or twice a week, no more than 10 minutes," said Challis, the former head of the British committee that studied cell phones and radiation. "I use a land line whenever I can."  It's the exposure, day after day, year after year, that matters.  As Challis, who's retired, puts it, "If I were younger, I'd take this much more seriously."

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Women have more bacteria on their hands than men-keralitesgroup

Women have more bacteria on their hands than men Washington: Wash your hands, folks, especially you ladies. A new study found that women have a greater variety of bacteria on their hands than men do. And everybody has more types of bacteria than the researchers expected to find. "One thing that really is astonishing is the variability between individuals, and also between hands on the same individual," said University of Colorado biochemistry assistant professor Rob Knight, a co-author of the paper. "The sheer number of bacteria species detected on the hands of the study participants was a big surprise, and so was the greater diversity of bacteria we found on the hands of women," added lead researcher Noah Fierer, of University of Colorado. The researchers aren't sure why women harbored a greater variety of bacteria than men, but Fierer suggested it may have to so with the acidity of the skin. Knight said men generally have more acidic skin than women. Other possibilities are differences in sweat and oil gland production between men and women, the frequency of moisturizer or cosmetics applications, skin thickness or hormone production, he said. Women also may have more bacteria living under the surface of the skin where they are not accessible to washing. Asked if guys should worry about holding hands with girls, Knight said: "I guess it depends on which girl." He stressed that "the vast majority of the bacteria we have on our body are either harmless or beneficial ... the pathogens are a small minority."

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