Plant sterols, found in Benecol and Flora proactive, are associated with an increased risk of coronary artery disease

This study was published in Steroids 2015 Mar 23

Study title and authors:
Increased plant sterol deposition in vascular tissue characterizes patients with severe aortic stenosis and concomitant coronary artery disease.

Luister A, Schött HF, Husche C, Schäfers HJ, Böhm M, Plat J, Gräber S, Lütjohann D, Laufs U, Weingärtner O.
Klinik für Innere Medizin III¸Kardiologie, Angiologie und Internistische Intensivmedizin.

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25814070

Phytosterols are present in very small quantities in fruit and vegetables. The phytosterol content of plant sterol-enriched margarines (Benecol, Flora proactive etc) are higher by an order of magnitude of up to 841 times than the average vegetable (see here). Campesterol and sitosterol are types of phytosterols.

Oxyphytosterols are phytosterols that have gone rancid.

Cholestanol is a derivative of cholesterol.

The aim of the study (of 104 patients) was to evaluate the relationship between phytosterols, oxyphytosterols, lathosterol, cholestanol and cholesterol in patients with severe aortic stenosis (artery blockages), some of whom also had coronary artery disease who were scheduled for elective aortic valve replacement.

The study found:
(a) The ratio of campesterol-to-cholesterol was increased by 26% in plasma of patients with coronary artery disease compared to those without coronary artery disease.
(b) Sitosterol concentrations were increased by 38.8% in the tissues of patients with coronary artery disease compared to those without coronary artery disease.
(c) Campesterol concentrations were increased by 30.4% in the tissues of patients with coronary artery disease compared to those without coronary artery disease.
(d) Oxidized sitosterol-to-cholesterol ratios were up-regulated by 22.7% in the plasma of patients with coronary artery disease compared to those without coronary artery disease.
(e) Oxidized campesterol was increased by 17.1% in the aortic valve cusps (the triangular fold or flap of a heart valve) of patients with coronary artery disease compared to those without coronary artery disease.
(f) Neither cholestanol nor the ratio of cholestanol-to-cholesterol was associated with coronary artery disease.

Luister concluded: "Patients with concomitant coronary artery disease are characterized by increased deposition of plant sterols, but not cholestanol in aortic valve tissue. Moreover, patients with concomitant coronary artery disease were characterized by increased oxyphytosterol concentrations in plasma and aortic valve cusps".

Is it wise to consume margarines high in phytosterols (such as Benecol and Flora proactive) when the study suggests that phytosterols are associated with a higher risk of coronary artery disease?

Rhabdomyolysis occurring under statins after intense physical activity in a marathon runner

This paper was published in Case Reports in Rheumatology 2015;2015:721078

Study title and authors:
Rhabdomyolysis Occurring under Statins after Intense Physical Activity in a Marathon Runner.

Toussirot É, Michel F, Meneveau N.
Clinical Investigation Center for Biotherapy, CIC-1431, FHU INCREASE, University Hospital of Besançon, 25000 Besançon, France

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25815236

This paper reports the case of a marathon runner who developed rhabdomyolysis.

(i) A 50 year old man healthy man started to take atorvastatin but soon suffered from severe muscle pain. He then was prescribed rosuvastatin.
(ii) The patient was a regular long-distance and marathon runner. He was preparing for an international competition.
(iii) On the day of the competition and while being still under rosuvastatin, the patient experienced progressively worsening muscular weakness. At the end of the race, he suffered from severe pains in the lower limbs similar to diffuse cramps associated with generalized muscle contraction.
(iv) Muscle enzymes (creatine kinase) were tested two days after the race and were at 2631 IU/L (normal levels 300) and he was diagnosed with rhabdomyolysis.
(v) One year later, (without taking the statins), for another marathon, the patient felt no muscle weakness at all or muscle contractions after the race.

Toussirot concluded: "Intense physical activity, as performed by statin treated athletes (whether professional or not and particularly during long-distance races) could have adverse consequences on muscles".

Acute exacerbations and infections increase in patients with chronic obstructive pulmonary disease who take aspirin and statins

This study was published in the International Journal of Medical Sciences 2015 Mar 2;12(3):280-7

 

Study title and author:

No Significant Detectable Anti-infection Effects of Aspirin and Statins in Chronic Obstructive Pulmonary Disease.

Yayan J.

Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, Saarland University Medical Center, Homburg/Saar, Germany.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25798054

Chronic obstructive pulmonary disease is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease.

This study examined  the effect of using aspirin and statins in the exacerbation and infection in patients with chronic obstructive pulmonary disease. The study included 300 patients, average age 69 years, with chronic obstructive pulmonary disease.

The study found:
(a) Patients taking aspirin and statins were 40% more likely to develop an infection than not develop an infection.
(b) Patients taking statins alone were 230% more likely to develop an infection than not develop an infection.
(c) Patients not taking either aspirin or statins were 40% LESS likely to develop an infection than develop an infection.
(d) Patients taking aspirin and statins had a 16% increased risk of acute exacerbation of chronic obstructive pulmonary disease compared to patients not taking either aspirin or statins.
(e) Patients taking statins alone had a 56% increased risk of acute exacerbation of chronic obstructive pulmonary disease compared to patients not taking either aspirin or statins.

Yayan concluded: "In this study, the number of acute exacerbations and infections increased in patients with chronic obstructive pulmonary disease who took aspirin and statins compared with those who took neither aspirin nor statins".

Women who consume diet drinks have a higher risk of cardiovascular disease

This study was published in the Journal of General Internal Medicine 2014 Dec 17

Study title and authors:
Diet Drink Consumption and the Risk of Cardiovascular Events: A Report from the Women's Health Initiative.

Vyas A, Rubenstein L, Robinson J, Seguin RA, Vitolins MZ, Kazlauskaite R, Shikany JM, Johnson KC, Snetselaar L, Wallace R.
Division of Cardiovascular Medicine, University of Iowa Hospitals & Clinics, 200 Hawkins Dr., Int. Med. E316-1 GH, Iowa City, IA, 52242, USA, ankurvyas7@gmail.com.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25515135

This study aimed to evaluate the relationship between diet drink intake and cardiovascular events. The study included 59,614 post-menopausal women, average age 62.8 years, who were followed for 8.7 years.

The study found:
(a) Women who consumed two or more diet drinks per day had a 30% higher risk of cardiovascular disease events compared to women who consumed 0-3 diet drinks a month.
(b) Women who consumed two or more diet drinks per day had a 50% higher risk of cardiovascular disease deaths compared to women who consumed 0-3 diet drinks a month. 
(c) Women who consumed two or more diet drinks per day had a 30% higher risk of overall deaths compared to women who consumed 0-3 diet drinks a month.

Vyas concluded: "This analysis demonstrates an association between high diet drink intake and cardiovascular disease outcomes and mortality in post-menopausal women".

Statins may increase the risk of liver disease in patients with Graves orbitopathy

This study was published in the Journal of Clinical Endocrinology and Metabolism 2015 Mar 9

Study title and authors:
STATINS MAY INCREASE THE RISK OF LIVER DISFUNCTION IN PATIENTS TREATED WITH STEROIDS FOR ACTIVE GRAVES' ORBITOPATHY.

Covelli D, Vannucchi G, Campi I, Currò N, D'Ambrosio R, Maggioni M, Gianelli U, Beck-Peccoz P, Salvi M.

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25751109

Graves' orbitopathy is an autoimmune inflammatory disorder affecting the orbit around the eye, characterized by upper eyelid retraction, lid lag, swelling, redness, conjunctivitis, and bulging eyes.

Graves' orbitopathy is often treated with methylprednisolone (an intravenous glucocorticoid). Often patients with Graves' orbitopathy and using an intravenous glucocorticoid, are also treated with statins.

This paper records the cases of two patients, (a 64 years old man and a 58 years old woman), who were prescribed methylprednisolone and concomitant administration of statins.

In the 64 year old man:
(a) After starting simvastatin and methylprednisolone he suffered from liver dysfunction. (His liver enzymes were significantly increased).
(b) He stopped taking simvastatin and methylprednisolone.
(c) He restarted methylprednisolone (but not simvastatin) and his liver enzymes returned to normal.

In the 58 year old woman:
(d) After starting rosuvastatin and methylprednisolone she suffered from liver dysfunction. (Her liver enzymes were significantly increased).
(e) She stopped taking methylprednisolone but continued rosuvastatin.
(f) Her live enzymes increased further.
(g) Three weeks later she stopped the rosuvastatin and there was a progressive normalization of her liver enzymes.

Covelli concluded: "Our study shows that statins, when concomitantly employed with methylprednisolone, may be a cause of liver dysfunction during intravenous glucocorticoid in active Graves' orbitopathy".

Statins and low cholesterol associated with a higher risk of Parkinson's disease

This study was published in Movement Disorders 2015 Jan 14

Study title and authors:
Statins, plasma cholesterol, and risk of Parkinson's disease: A prospective study.

Huang X, Alonso A, Guo X, Umbach DM, Lichtenstein ML, Ballantyne CM, Mailman RB, Mosley TH, Chen H.
Department of Neurology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25639598

This study examined the relationship between cholesterol levels and statin use in relation to Parkinson's disease. The study included 15,792 participants, aged 45-64 years, who were followed for 11 years.

The study found:
(a) Statin users had a 139% higher risk of Parkinson's compared to non-users.
(b) Those with the highest cholesterol had a 57% reduced risk of Parkinson's compared to those with the lowest cholesterol.

Professor Huang concluded: "Statin use may be associated with a higher Parkinson's disease risk, whereas higher total cholesterol may be associated with lower risk".

Statins associated with elevated risk of high-grade prostate cancer

This study was published in the European Journal of Cancer 2015 Feb 23. pii: S0959-8049(15)00124-0

 

Study title and authors:

The risk of prostate cancer for men on aspirin, statin or antidiabetic medications.

Nordström T, Clements M, Karlsson R, Adolfsson J, Grönberg H.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25727881

This study estimated the association between prescribed medications and the risk of either any prostate cancer or high-grade prostate cancer. The study included 185,667 men having a first recorded prostate specific antigen test and 18,574 men having a first prostate biopsy.

Regarding statins, the study found:
(a) Men using statins had a 16% increased risk of any prostate cancer compared to men not taking statins.
(b) Men using statins had a 25% increased risk of high-grade prostate cancer compared to men not taking statins. 

Nordstrom concluded: "Use of any statins was associated with an elevated risk of being diagnosed with high-grade prostate cancer".

Statins increase the risk of diabetes by 46%

This study was published in Diabetologia DOI 10.1007/s00125-015-3528-5

Study title and authors:
Increased risk of diabetes with statin treatment is associated with impaired insulin sensitivity and insulin secretion: a 6 year follow-up study of the METSIM cohort
Henna Cederberg & Alena Stančáková & Nagendra Yaluri & Shalem Modi & Johanna Kuusisto & Markku Laakso
Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland and Kuopio University Hospital

This study can be accessed at: http://www.medscape.com/viewarticle/840884

The aim of this work was to investigate the mechanisms underlying the risk of type two diabetes associated with statins. The study included 8,749 non-diabetic men, aged 45–73 years, who were followed up for 5.9 years.

The study found:
(a) Individuals taking statins had a 46% increased risk of developing diabetes compared to individuals not taking statins.
(b)  Insulin sensitivity was decreased by 24% in individuals on statin treatment compared with individuals without statin treatment.
(c)  Insulin  secretion was decreased by 12% in individuals on statin treatment compared with individuals without statin treatment.

Cederberg concluded: "Statin treatment increased the risk of type 2 diabetes by 46%, attributable to decreases in insulin sensitivity and insulin secretion".

Positive review of my books in Caduceus magazine by Dr Rajendra Sharma

My books "Cholesterol And Saturated Fat Prevent Heart Disease" and "Low Cholesterol Leads To An Early Death" have received positive reviews in issue 80 (page 11) of Caduceus magazine by Dr Rajendra Sharma.

Statin use is significantly associated with cataract requiring surgical intervention

This study was published in the Canadian Journal of Cardiology 2014 Dec;30(12):1613-9

Study title and authors:
Statin use and risk for cataract: a nested case-control study of 2 populations in Canada and the United States.

Wise SJ, Nathoo NA, Etminan M, Mikelberg FS, Mancini GB.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25475465

This study examined the effect of statin use on the risk of cataract and need for surgical intervention. Data was derived from two health databases: The British Columbia Ministry of Health database and the IMS LifeLink database (US health claims database). The British Columbia Ministry of Health database included 162,501 male and female cataract patients who were matched with 650,004 control subjects. The IMS LifeLink database comprised of male patients aged 40-85 years; 45,065 cataract patients were matched with 450,650 control subjects.

The study found:
(a) In the British Columbia group, statin users had a 27% increased risk of cataract requiring surgical intervention compared to nonusers.
(b) In the IMS LifeLink group, statin users had a 7% increased risk of cataract requiring surgical intervention compared to nonusers.

Wise concluded: "This study demonstrates that statin use is significantly associated with cataract requiring surgical intervention.".