<Lipitor>
Seems to be the best of the statins in my view. Or more precisely, there's currently more evidence for it being good than for any of the others, which may have something to do with Pfizer's willingness to spend big bucks on trials.
But at high doses it still has risks. I personally would add Niaspan before going to a high dose of a statin, and I'd stay completely away from Crestor - I just don't believe that lowering cholestorol by itself is a good thing. (I believe Crestor will still sell well, but that's a different topic).
For general cardiac health it's pretty clear a Mediterranean diet is the way to go - olive oil, fish, wine, fruits, nuts and vegetables. (And of course exercise).
In terms of supplements, the only clear ones are those that reduce homocysteine - notably folic acid and B6. But again I'd argue for moderation - vitamins sometimes start acting as drugs when you take them in huge mega-doses, and as drugs they have generally not been well studied. I'd say on balance the evidence also supports Co-Q10 supplements for those taking statins. For those that don't eat fish at least twice a week, fish oil supplements seem like a good idea as well. Fish consumption dramatically reduces sudden cardiac death - seems to somehow prevent arrythmias in those who have mild heart attacks. (There was a NEJM article on this a year or two ago).
Peter (who of course is not a doctor or a scientist) |
