Lipidil

SOME PATIENTS have gotten the facts about heart disease scrambled; believing the common myths listed below can be hazardous to their health. Here's the information you need to set them straight.

MYTH: Medicines for cholesterol will damage the liver, so you shouldn't take them.

FACT: Lipid-lowering drugs are metabolized in the liver, and can cause damage if the patient has a history of liver disease or active liver disease, or consumes large quantities of alcohol. All patients should have blood tests as recommended to monitor for adverse reactions.

These drugs are used as adjuncts (not first-line therapy) in patients who have high cholesterol levels despite following a good diet, maintaining ideal body weight, and exercising to help reduce the risk of heart disease.

We're fortunate to live in an age when we have medications that help us reach desirable levels of "good" cholesterol (high-density lipoprotein [HDL]) and "bad" cholesterol (lowdensity lipoprotein [LDL]) and reduce the risk of atherosclerosis. Agents such as simvastatin (Zocor), lovastatin (Mevacor), pravastatin (Pravachol), cerivastatin (Baycol), and atorvastatin (Lipitor) can lower even markedly elevated levels of LDL cholesterol. Fibrate agents such as gemfibrozil (Lopid) and fenofibrate (Tricor, Lipidil) lower triglycerides and raise HDL cholesterol. Niacin, a vitamin, has now been developed in a long-acting formulation (Niaspan), which lowers LDL cholesterol and triglycerides, raises HDL cholesterol, and lowers the amount of other toxic types of cholesterol, such as lipoprotein (a).

Abundant evidence from welldesigned clinical trials shows that these agents lower the risk of myocardial infarction and stroke and the need for cardiac bypass surgery by as much as 40%.

MYTH: Exercise may help you lose weight and look good, but you won't live any longer.

FACT: Even a little exercise can go a long way: A recent study in Hawaii found that men who walked 1 to 2 miles per day reduced their mortality rates by 35%. Exercise can help you lose weight, which helps lower cholesterol and blood pressure; improves a person's sense of well-being; and may even decrease the symptoms of depression. Best of all, no one needs to join a health club or buy home exercise equipment to benefit: Just walking 15 minutes a day can make a difference.

MYTH: As long as food is labeled "no cholesterol;' it's okay.

FACT: Cholesterol isn't the only thing you want to avoid in your diet. Saturated fat causes the liver to produce more LDL cholesterol. Polyunsaturated fats are less harmful, but monounsaturated fats-such as those found in olive and canola oil-may be the most protective of all.

A healthful, tasty diet is the "Mediterranean Diet," with modest amounts of meat, significant monounsaturated fat, and lots of fresh fruits and vegetables.

The bottom line: Read labels carefully so you know what you're getting. Some "no cholesterol" foods aren't as healthful as their manufacturers would like you to believe.

MYTH: Drinking alcoholic beverages every day is good for you.

FACT: In moderate amounts (about two drinks per day), red wines and dark beers seem to increase the amount of HDL cholesterol. In large quantities, however, alcohol damages the body. Because alcohol is the most abused drug in the world, encouraging people to drink more doesn't seem wise. Other beverages, such as tea and grape juice, also provide antioxidant benefits, without the adverse effects that plague alcohol.

Source: '"Twelve Dangerous Myths about Heart Disease," by Darrell J. Youngman, DO, FACC, FACP, Medical Director, HeartPoint, http://www.heartpoint.cond dozendangers.html. Adapted with permission of the author.

Copyright Springhouse Corporation Apr 2000
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