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Showing posts with label Blood and Urine Test Results. Show all posts
Showing posts with label Blood and Urine Test Results. Show all posts

Monday 19 September 2022

High cholesterol levels: Why taking your medicine diligently is more effective than changing your diet

 


No one likes the idea of popping pills every morning. Take cholesterol-lowering medicines or statins, for example. To get themselves off the hook, many patients with high cholesterol levels tend to believe that diet changes and other lifestyle modifications alone would work.

Interestingly, when it comes to lowering cholesterol levels, being diligent with your medicine is far more beneficial than giving up wagyu beef. A local study by SingHealth Polyclinics (SHP) has found “adherence to medication to be the most critical factor” compared to other considerations such as ethnicity, diet, exercise and smoking.

Just how much more effective? Professor Tan Huay Cheem, a senior consultant with the Department of Cardiology at National University Heart Centre, Singapore, who isn’t part of the study, provided the breakdown below:

Diet: 10 per cent to 20 per cent

Exercise: 5 per cent

Exercise and diet: 10 per cent to 20 per cent

Medicine (oral): 30 per cent to 50 per cent

Medicine (oral and injectable): Up to 85 per cent

Dr Tan Ngiap Chuan, who led the study and is the director of research at SHP, said the findings could prompt doctors to prioritise starting or adjusting medications with their patients. "We usually focus on other lifestyle factors first. We may switch the order now."

(Photo: iStock/MStudioImages) 
 
 

HOW DO THESE MEDICINES WORK?

In Singapore, nearly two out of 10 adults aged 18 to 69 have high cholesterol, according to the SHP study.

If you’re one of them, you’re probably put on statins (including atorvastatin and rosuvastatin), the most commonly prescribed medicine, said Prof Tan.

Statins are also known as HMG-CoA reductase inhibitors and they “work in the liver to prevent cholesterol from forming and reduce the amount of cholesterol circulating in the blood”.

“They are most effective at lowering LDL (bad) cholesterol, but also help to lower triglycerides and raise HDL (good) cholesterol,” said Prof Tan.

In addition to statins, a new class of injectables have emerged in recent years. They provide an alternative for patients “who are unable to achieve their targeted cholesterol levels, who are statin intolerant, or unable to adhere to regular therapies”, said Prof Tan. 

 

These include the PCSK9 inhibitors (such as evolocumab and alirocumab), which are injected once every two weeks.

There are also the small interfering RNA or siRNA, which requires subcutaneous injection only once every six months. These siRNA include inclisiran, which was recently approved by Singapore’s Health Sciences Authority and the US Food and Drug Administration, said Prof Tan. “The injectables can be used in combination with oral medicines.”

Unfortunately, the commonly prescribed statins have received bad press on social media, said Prof Tan, even though they have been “proven to be effective in preventing heart attacks, strokes and death – even among low-risk patients”. It has led patients to develop “unfounded fears” for statin-associated side effects, he said.

Here, Prof Tan tackles some of the common misconceptions patients have about statins:

MISCONCEPTION 1: Doctors prescribe statins as a catch-all

 

 (Photo: iStock/wutwhanfoto) 

 

Statins are widely used as they satisfy two crucial functions in disease management: Preventing the onset of disease before it begins; and reducing the severity or impact of a disease if it already has by “halting its progress and preventing recurrences”, said Prof Tan.

“Certainly, patients who are at low risk for heart attack and stroke will benefit less from taking statins,” he said. But “among medical experts, there is little debate on whether statins work in high-risk patients”.

Having said that, statins aren’t prescribed indiscriminately. According to Prof Tan, patients are usually started on a course only if they satisfy any of these criteria:

Atherosclerotic cardiovascular disease. This means the patient has pre-existing blockages in the heart, brain or any arteries in the body’s circulatory system.

Diabetes mellitus. Especially those who have been living with diabetes for more than 10 years.

High LDL cholesterol level. Higher than 190mg/dL (4.9mmol/L).

As prevention. These are patients with no established cardiovascular disease but have multiple risk factors that increase their chances of developing it in the future.

MISCONCEPTION 2: Once you start on statins, you have to be on them for life

(Photo: iStock/Hailshadow) 
 

This is true, though. The cholesterol-lowering benefits conferred by statins will only continue for as long as you take the medicine, said Prof Tan. “The cardio-protective effect is lost when the statins are stopped.” You would have considered to have discontinued your medication if you stopped for more than a year.

Perhaps the more pertinent question is: What are the effects of being on statins in the long run? “Studies have shown that statins are safe and well tolerated. They have been used for more than 30 years to lower cholesterol. In fact, statins work best when you take them for a long time,” said Prof Tan.

Look at it as insurance for a longer life and to prevent heart attacks and strokes, he added.

MISCONCEPTION 3: Statins cause diabetes 

 

(Photo: iStock/hinnapong) 

 

Statins have been found to slightly elevate blood sugar levels in clinical trials, said Prof Tan. And this creates the impression that statins can lead to diabetes.

“However, people experiencing this side effect are already prediabetic or have higher than normal blood sugar. For those who are borderline diabetic, this mild increase in blood sugar can lead to a diabetes diagnosis about five weeks earlier than it would be otherwise,” he said.

But if you’re not already predisposed to diabetes, that is, your blood sugar levels are normal, statins do not induce diabetes, said Prof Tan.

“Additionally, the benefits of reducing cardiac events in someone who has prediabetes or is diabetic greatly outweigh the slight increase in their blood sugar which may occur,” he said.

MISCONCEPTION 4: Statins destroy muscle tissue

 
(Photo: iStock/Marc Bruxelle)
 

The muscle-destroying conditions that you might have read about are known as myopathy and rhabdomyolysis. “Serious muscle damage such as myopathy and rhabdomyolysis are rare,” said Prof Tan.

Myopathy refers to any disease that causes the muscles to lose control, leading to muscle weakness. Rhabdomyolysis, on the other hand, results from the disintegration of the muscle fibres. Both conditions have been linked to the frequent use of statins.

Prof Tan said that statin-associated muscle symptoms have been reported in studies in varying frequencies, from 10 per cent to 15 per cent in patients. However, he claimed that the incidence rate may be overestimated due to the nocebo effect.

The cardio-protective effect is lost when the statins are stopped. In fact, statins work best when you take them for a long time.

“This is when a patient with negative expectations of a medicine would experience its potential side effects at a much higher rate than he otherwise would,” said Prof Tan.

If you suspect you have statin-associated muscle symptoms, the ache and tenderness typically involve large muscle groups such as the shoulders and the thighs, and are usually bilateral. They also tend to be more pronounced after physical exercise, said Prof Tan.

Speak to your doctor who can put you on a different statin or reduce the dose, he said.

MISCONCEPTION 5: Statins do not really prevent vascular disease

 
(Art: iStock/Rasi Bhadramani)

Vascular disease refers to any condition that affects the blood vessels in your body. As you’d already know, having a high cholesterol level means that you have a high amount of fat and cholesterol deposits coursing through your blood vessels that can accumulate and block the vessels. When that happens, you run a high risk for cardiovascular diseases such as heart attacks and strokes.

“Lowering cholesterol levels reduces the risk of such events,” said Prof Tan.

And what about statins’ contribution? “In the high-risk populations studied, those who took statins had 20 per cent to 40 per cent fewer heart attacks, strokes and deaths than those who did not over two to five years,” said Prof Tan.

“Statin therapy is also the standard of care for patients with peripheral artery disease (that is, blockages that occur in the lower limb arteries) in all the international guidelines.”

Source: CNA/bk Source link

 


Storvas C®

Kegunaan:

        1. Menurunkan tahap kolesterol LDL

        2. Mengurangkan risiko serangan jantung dan angin ahmar (strok)

Cara pengambilan:

1-4 biji 1 kali sehari selepas makan pada waktu malam

Kesan sampingan:

Kesan sampingan yang biasa:

  • Cirit-birit (sehingga 14.1%)

  • Sakit sendi (sehingga 11.7%)

  • Sakit otot (sehingga 8.4%)

  • Hidung tersumbat atau bersin (sehingga 8.3%)

Sila beritahu doktor jika kesan sampingan tersebut berterusan atau bertambah teruk.

Kesan sampingan yang serius tetapi jarang berlaku:

  • Reaksi alahan ubat (ruam, bengkak mulut atau mata, sesak nafas)

  • Sakit otot yang tidak dapat dijelaskan atau lemah

  • Peningkatan enzim hati

  • Pendarahan otak

Sila beritahu doktor dengan segera jika mengalami kesan sampingan yang serius.

Ini bukanlah senarai lengkap kesan-kesan sampingan yang boleh berlaku. Sila hubungi doktor atau pegawai farmasi untuk maklumat lanjut. 

Penggunaan jika mengandung:

Kategori X: Elakkan penggunaan – kajian telah menunjukkan kesan mudarat dan boleh menyebabkan kecacatan kepada janin

Penggunaan jika menyusukan anak:

Elakkan penyusuan – terdapat risiko kesan mudarat kepada bayi

Kontraindikasi:

        • Sejarah reaksi alahan terhadap ubat ini atau bahan dalam ubat ini

        • Penyakit hati

        • Peningkatan enzim hati secara berterusan tanpa sebab yang diketahui

Sila huAtorvastatin 20 mg Film-coated Tablets – (emc) bungi doktor atau pegawai farmasi anda untuk maklumat lanjut

 --------------------------------------------------------------------------

Brand:Storvas C® Usage:

    Lowers LDL cholesterol levels
    Reduces the risk of heart attack and stroke

How to take:
1-4 seeds 1 time a day after eating at night
Side effect:
Common side effects:

    Diarrhea (up to 14.1%)
    Joint pain (up to 11.7%)
    Muscle pain (up to 8.4%)
    Stuffy nose or sneezing (up to 8.3%)

Please tell your doctor if these side effects persist or worsen.
Serious but rare side effects:

    Allergic drug reaction (rash, swelling of the mouth or eyes, shortness of breath)
    Unexplained muscle pain or weakness
    Increased liver enzymes
    Brain hemorrhage

Please tell your doctor immediately if you experience any serious side effects.

This is not a complete list of possible side effects. 
Please contact your doctor or pharmacist for more information.
Use if pregnant:
Category X: Avoid use – studies have shown harmful effects and may cause birth defects
Use if breastfeeding:
Avoid breastfeeding – there is a risk of harm to the baby
Contraindications:

    History of allergic reactions to this drug or ingredients in this drug
    Liver disease
    Persistent elevation of liver enzymes for no known reason

Please contact your doctor or pharmacist for more informationJenama:

----------------------------------------------------------------------------

 

Storvas 40 MG Tablet

Manufactured byRanbaxy Laboratories Ltd.
 
ContainsAtorvastatin
 
Description
Storvas 40 MG Tablet is a medicine consisting of Atorvastatin. It is used in the treatment of high blood cholesterol and triglycerides (fats) levels. This medicine works by blocking the production of unhealthy fats in your body and prevents the risk of heart problems and stroke (a condition that causes reduced oxygen supply to the brain).

Storvas 40 MG Tablet has some side effects like nausea, weakness, muscle pain, stomach pain, etc. These side effects are mild and may subside by themselves. Consult your doctor if these side effects last for a long time or worsen.

Storvas 40 MG Tablet may be taken with or without food. Take the dose as directed by your doctor. Take it regularly at the same time for the ease of remembering. Avoid taking more than the recommended dose. Your doctor may suggest tests to regularly monitor your lipid profiles (fat levels in the blood) to make sure the medicine is working properly.

Storvas 40 MG Tablet is not recommended for use if you are allergic to it. Avoid taking this medicine if you have liver problems. Use this medicine with caution if you have diabetes, hypothyroidism (low levels of thyroid hormone in the body), or kidney problems. Inform your doctor if you are taking any other medicine as they may interact with this medicine and cause undesired effects.

Storvas 40 MG Tablet is not recommended for use in children below 10 years of age as the safety and efficacy data is not available. Consult your doctor if you are pregnant, planning a pregnancy, or are breastfeeding. 
 
 Atorvastatin

Description 

Atorvastatin is a cholesterol-lowering medicine. It works by blocking the action of an enzyme responsible for the production of cholesterol in the body. Thus, it helps in reducing blood cholesterol levels. It also prevents the risk of heart problems.

Atorvastatin may cause common side effects such as headache, nausea, diarrhoea/constipation, indigestion, muscle pain, stuffy nose, etc. Consult your doctor if these symptoms persist for a long time or if they become severe.

Atorvastatin can be taken with or without food as instructed by your doctor. Take it at the same time every day to maintain a constant level of this medicine in your body. Do not skip a dose or discontinue the treatment without consulting your doctor.

Atorvastatin is not recommended if you are allergic to it, or have liver problems. Inform your doctor if you have diabetes as this medicine may affect your blood sugar control. This medicine is not recommended for use if you are pregnant or are breastfeeding.