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Prescription Drug Risks for Elders-part 2

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In the first of my present series of postings on recent Food and Drug Administration (FDA) warnings, I had talked about new evidence of long term health risks from some pain medications that are available both in prescription and over the counter (OTC).  In this posting, I am going to share with you another FDA warning, this one for prescription medications that lower cholesterol.  The “family” of medications is commonly called statins and includes some very well known brands that many of you have seen advertised on television and in magazines.  Others of you or the people you care for may also be taking these medications.

All Americans have been alerted to the risks posed by increasingly high levels of cholesterol many of us have in our bloodstreams owing to eating foods high in fats or just plain eating too much.  One way to address the elevated “bad cholesterol” or low density lipids (LDLs) is through diet and exercise.  But for people with persistently high LDL, a physician may also prescribe one of the many statins available.  These go by names like Crestor, Lipitor, Zocor, Levacor and Pravachol, and when taken as directed, they do help to reduce LDL levels.  Research published in the June 22-29, 2011, issue of the Journal of the American Medical Association looked at a number of individual studies which had showed a link between high-dose statin use and diabetes as well as a risk for cardiovascular events.

The researchers pooled the findings of five different and large clinical studies of moderate- and high-dose statin use among patients.  These studies followed patients for a number of years and the results over time were pretty compelling. 

When the researchers compared the moderate and high-dose groups at the end of the nearly five years of the research, the high-dose group had 12 percent greater chance of developing type 2 diabetes than the moderate-dose statin users.  But the high-dose users of one of the statins, Lipitor, experienced a 16 percent lower likelihood of having some sort of cardiovascular event like a heart attack, stroke or even death.  The other statin studied did not offer any cardiovascular benefit.  It is not clear how other statins fared in terms of heart health.  The diabetes link was the most consistent across medications.

As with a lot of modern medicine, the devil is in the details.  It seems that high-dose statins pretty uniformly put patients more at risk than moderate-dose statins for diabetes.  It is important to appreciate that these are significant differences, but even then, the numbers of patients who may expect an issue to develop will be quite small.  As always, consult with your primary care physician or cardiologist about your medications of those of the elder for whom you provide care.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management , certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families throughout metropolitan Chicago.  Please email your questions to Charlotte Bishop.

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