Don’t miss a beat! Get involved with October’s National Cholesterol Month

As a long-term provider of popular high-cholesterol treatments such as Lipitor and Crestor, Medical Specialists® Pharmacy are proudly supporting October’s National Cholesterol Month 2015, organised by the charity HEART UK to raise more awareness about what cholesterol is, the often underestimated serious health risks associated with high cholesterol, and what can be done to lower the low-density lipoprotein (LDL) – also known as ‘bad cholesterol’.

What is cholesterol?

For those unaware of what cholesterol actually is, it is a fatty, waxy substance known as a ‘lipid’, located in all of the body’s cells. The body requires some cholesterol to produce hormones, vitamin D, and substances to aid food digestion, and will produce what it needs, but some of the food we eat also contains cholesterol.

Cholesterol travels through the bloodstream in small packages that go by the name of lipoproteins. The two main types of lipoprotein are:

. High-density lipoprotein (HDL) – HDL carries cholesterol away from the cells and back to the liver, where it’s either broken down or passed out of the body as a waste product. For this reason, HDL is referred to as ‘good cholesterol’ and higher levels are better.

. Low-density lipoprotein (LDL) – LDL carries cholesterol to the cells that need it. If there’s too much cholesterol for the cells to use, it can build up in the artery walls, leading to disease of the arteries. For this reason, LDL is known as ‘bad cholesterol’.

High cholesterol – i.e. high levels of the bad LDL cholesterol – itself will not usually cause any symptoms, but it increases a person’s risk of serious health problems.

For example, plenty of evidence shows that high cholesterol can raise the risk of suffering with heart attack, heart disease, stroke, narrowing of the arteries (atherosclerosis), transient ischaemic attack (known as a ‘mini-stroke’) and peripheral arterial disease.

These risks are due to the fact cholesterol accumulate within the artery wall, reducing blood flow to the heart, brain and other areas of the body. In addition, the risk of a blood clot is also increased with high cholesterol.

What causes high cholesterol?
There are a number of contributing factors to a person having high blood cholesterol, some lifestyle choices, others being related to underlying conditions and there is also a risk if there has been a family history of such problems.

Lifestyle choices that can cause high cholesterol include a lack of exercise or physical activity, drinking too much alcohol, having a diet high in saturated fat and being a smoker. People with diabetes or high blood pressure usually also have high cholesterol.

Highlighting the risks of ‘The Silent Killer’ high cholesterol is imperative for HEART UK during National Cholesterol Month for many reasons, but one of those is to educate people about a condition many will not be aware of, but can be deadly – Familial hypercholesterolaemia (often shortened to FH).

FH is inherited, passed on by one of your parents and can cause incredibly high levels of cholesterol. Those with FH have high cholesterol levels from birth, whereas most people’s cholesterol increases with age and could be 50, 60 or 70 years of age before their cholesterol is deemed to be at a level linked to an increased risk of major heart problems.

Some people may never display any symptoms, but the common signs of FH are lumps and bumps around the knuckles or Achilles tendon (due to cholesterol deposits), yellow cholesterol build-up around the eyes and eyelids, or a pale ring around the iris.

If, after going to the doctor for a cholesterol check and it is found to be significantly high, the doctor may refer the patient to a specialist for an assessment if he or she believes that patient has FH, which could include gene tests. The specialist will then explain which family members need to be assessed too and medication will likely be required, as healthy lifestyle choices alone are not enough to reduce cholesterol for anyone with FH.

Treating high cholesterol

Adhering to a healthy diet that is low in saturated fat and engaging in regular exercise to maintain a healthy weight/BMI can lower the level of cholesterol in the blood, or prevent cholesterol levels being too high to begin with. The higher the cholesterol level, the higher the risk of stroke or heart disease and therefore the overall risk of having a heart attack.

Statin medication available today from Medical Specialists®, such as Atorvastatin, Pravastatin or Rosuvastatin, work to lower the LDL (‘bad’) cholesterol and raise the HDL (‘good’) cholesterol. Statins may be prescribed to certain people with risk factors for heart conditions, such as those with high cholesterol or high blood pressure, older patients, smokers, or those with family history of early heart disease. Between eight and ten million Britons take statins, making them the most widely prescribed drugs across the UK.

Get involved with National Cholesterol Month

HEART UK are providing expert, independent advice on statins and other cholesterol treatments, in addition to campaigning for improved detection of those at risk of high cholesterol and offering training for health professionals.

National Cholesterol Month 2014 was a roaring success, with more than £25,000 raised, but HEART UK are hoping to smash this amount for 2015, continuing with the theme the ‘Great Cholesterol Challenge’.

HEART UK state on their website how people can get involved and acquire a fundraising pack, saying: “Treat your heart by pledging to adopt a new healthy habit and raise funds for HEART UK at the same time! For this year’s campaign we have developed some really exciting ‘virtual challenges’ which we know you will love – see how you can get involved!

“Great Cholesterol Challenge packs are available now! If you would like a pack or need any further information about this year’s campaign, please email us and we will get one sent to you.”
Moreover, HEART UK offer advice on who should have cholesterol tests and how frequently to get one done:

•     Every 5 years if you are between the ages of 40 and 75.
•     Every 12 months if you are on cholesterol lowering medication.
•     Any child of a parent with inherited high cholesterol (FH) – by the age of 10.
•     First degree relatives of a person with FH – on being told of the risk.

“The NHS will provide you with a free cholesterol test if you fall into any of the above groups, speak to your Doctor or Practice Nurse about arranging your cholesterol test.”

Millions more to be eligible for cholesterol-boosting statins

The threshold for those eligible to take cholesterol-lowering statins has been drastically cut by medicines regulator the National Institute of Health and Care Excellence (NICE), meaning millions more adults in England, Wales and Northern Ireland will now be offered statins by doctors.

Under controversial guidelines from the watchdog, most men aged over 60 and women over 65 will now be advised to take statins such as Atorvastatin, Pravastatin or Rosuvastatin. This will be the case even if they are only at a one in 10 risk of developing cardiovascular disease. The current threshold is 20%.

NICE say the recommendation to take statins to an extra 4.5 million adults is necessary to avoid “a tragedy waiting to happen” by decreasing the numbers of people suffering with heart attacks and strokes.

Around 12.5 million people are currently eligible for the drugs, and the NHS could see costs of an extra £52 million annually from the extra 4.5 million patients being offered statin medication. Due to decreasing costs for the drugs, the total NHS bill for statins would actually still be less than what it was in 2012.

Speaking yesterday, the NICE guidance panel argued the recommendations were devised from the “biggest ever clinical trial” and that 50,000 lives could be saved each year if those now eligible regularly took statins.

However, that indeed could be one major stumbling block – getting patients to keep taking their treatment. NICE admit that statin uptake only stands at around 60% usually, and that benefits to be gained are more likely to be 4,000 lives saved each year in addition to 22,000 strokes and heart attacks averted.

One in three deaths in the UK are the result of cardiovascular disease. It is for this reason why statins remain the most prescribed type of medication on the NHS, with Medical Specialists™ Pharmacy also seeing massive amounts of patients requesting statins to help lower their ‘bad’ LDL cholesterol, whilst raising the ‘good’ HDL cholesterol!

Although some doctors have claimed the new guidelines for statins are primarily based on studies funded by the pharmaceutical industry, this has been quickly refuted by NICE.

Professor Mark Baker, director of the Centre for Clinical Practice at NICE, blasted that such claims were “ludicrous”.

“Nobody gets onto our guideline groups if they have any significant vested interest, especially a financial interest,” he commented. “Statins are safe and effective and it is a good deal for more people to have access to them under the NHS.”

Professor Peter Weissberg, the medical director at the British Heart Foundation, stressed the importance of positive lifestyle choices in lowering the risk of cardiovascular disease. He said: “Doctors will now be able to offer a statin to people at a lower risk, but their prescription is not mandated.

“Just as important is the emphasis on trying lifestyle changes before considering treatments with drugs.”

For example, lifestyle changes hinted at by Professor Weissberg include: quitting smoking, maintain a healthy weight, exercise regularly, consume alcohol only in moderation, manage stress levels better, have a diet rich in fruit and vegetables/limited in trans fats and keep your blood pressure under control.

Overwhelming evidence shows statins are ‘very effective and safe’

The benefits of cholesterol-boosting statins far outweigh the risks and the “jury is no longer out”, leading health experts said yesterday.

Six professors from British universities decided to wade into the fierce debate about Britain’s most prescribed type of medication, and said there is now overwhelming evidence clearly demonstrating cholesterol-lowering statins such as atorvastatin and rosuvastatin are “very effective and safe”.

Presently, there are an estimated seven million people prescribed statins in the UK alone, with the drug recommended for anybody who has a one in five or higher risk of suffering a heart attack or stroke in the proceeding 10 years, or who have already had a major cardiac event. However, there have been calls to widen the scope for who is eligible, with many health experts saying there should be more people taking them than the current guidelines recommend.

However, the heart drugs were in the news earlier this year when they made headlines for their apparent dangerous risks. In May for example, researchers involved in a study into statins published in the British Medical Journal (BMJ) were forced to backtrack on claims the drugs increased a patient’s diabetes risk, admitting the claims were incorrect.

Professor Sir Rory Collins, head of the Nuffield Department of Population Health at Oxford University, said: “Side effects could put off high-risk patients from ­taking their life-saving medication. Major vascular events such as heart attacks or stroke are life-changing events for many people so to avoid these is important. The benefits outweigh the risks. The evidence is substantial that the treatment is safe but it remains a choice but one they can only make if they are not misinformed.”

Professor Collins added that it was not uncommon for older people prescribed statins to have aches and pains, but that these symptoms were just as likely to be suffered by those not taking statins.

George Davey Smith, ­professor of clinical epidemiology at the ­University of Bristol, argued that 25 years of research had showed definitive evidence about the major benefits of statin use. He said: “The jury is no longer out on the cost/­benefit ratio.”

Peter Weissberg, ­medical director of the British Heart Foundation, added: “If you take a statin your risk will reduce of having a heart attack or stroke. If you are at negligible risk all you are doing is exposing yourself to a low risk of side effects.”

So it seems statins are here to stay for the long-term, with their efficacy and safety surely no longer in question.

After the BMJ story was published, the Medicines and Healthcare products Regulatory Agency (MHRA) were quick to publish a rebuttal, issuing a safety update reassuring patients that statins were safe.

They commented that 450 deaths from heart attacks, stroke or vascular failure would be avoided for each 10,000 patients treated, if patients at a 20% or higher risk of suffering one of these over a 10-year period were taking statins for at least five years.

The shocking truth about counterfeit drugs is laid bare

After speaking with many of the thousands of patients who choose Medical Specialists as their pharmacy, we are only too aware of the concerns, worries and hesitations that some people have when it comes to dealing with online pharmacies. We are part of a minority in that we are a fully registered, genuine pharmacy that prescribe genuine branded medication – No cheap and potentially fatal knock-offs like many online ‘pharmacies’!

And now an investigation carried out by WKYC’s Channel 3 News in America has exposed more of the murky, dangerous world of counterfeit drugs after shocking estimates show that around $75 billion worth of counterfeit drugs could have been obtained last year unknowingly.

Some may remember the widely reported 2012 case of fake cancer drug Avastin being circulated in the supply chain. The U.S. Food and Drug Administration (FDA) had to alert medical practices in the U.S. that were suspected to have purchased and used the fakes. Avastin is an injectable medicine that is used to treat cancers of the brain, colon, kidney and lung. It is usually administered to patients in clinics, hospitals, and doctors’ offices. The fake Avastin worryingly did not contain the medicine’s active ingredient, bevacizumab, resulting in patients not receiving much needed treatment.

The new investigation comprised of the purchasing of medications online that the investigators thought looked credible enough. The websites were found by searching ‘online pharmacy’ into Google. Then, they decided to try and obtain two incredible popular medications – erectile dysfunction treatment Viagra, and the ‘bad’ cholesterol-lowering medication Lipitor.

The websites offered a variety of medications; some being brand-name prescription medications, whilst others were cheaper generic alternatives. Proudly displayed on the websites were images of the American and Canadian flags, and pictures of what appeared to be doctors and pharmacists…So far so good.
However, next is where suspicions started to arise. ‘Female Viagra’ and ‘Viagra super active’ were just two of drugs being offered on some of the websites. Viagra has not been given approval to be used by women. Also, although the UK patent on Viagra expired earlier this year, meaning certain pharmaceutical companies can produce medications containing Sildenafil (Viagra’s active ingredient), Americans will have to patiently bide their time until 2020 for a generic alternative to hit their shores.
Therefore, ‘Viagra super active’ should ring alarm bells immediately! It is either Pfizer-made Viagra, or none at all! In a move that should also set alarm bells off, two websites shockingly offered free samples of prescription-only medications with orders, such as another erectile dysfunction treatment, Cialis. Obviously there are questions within a doctor’s consultation that need to be asked to patients before any prescription item is approved and dispensed to the patient.

After ordering Viagra and Lipitor from three websites, it was a few later before anything arrived. Packages then turned up from exotic locations like China, India and Pakistan, not America or Canada. Customs forms on the packages certainly raised eyebrows. One said the package contained ‘plastic beads’, another listed ‘cards’ and a third said ‘harmless medicine’.

The drugs seemed to be genuine upon a quick glance. However, one not-so-minor problem… received was a generic Lipitor – not what the investigators had paid for. In another order, only half of the Viagra tablets had arrived that had been ordered and paid for.

Next, the issue was; were the pills actually real? Samples of the drugs were then sent off to Pfizer’s lab in Groton, Conn., for testing.

Brian Donnelly is director of investigations for Pfizer Pharmaceuticals. He is a qualified pharmacist, with 22 years of FBI work under his belt. Donnelly explained some shocking things about how the tablets were most likely produced.

“The active ingredient in the chemical could be in one part of China. The person who makes the tablets could be in another part of China, and then the person who packages it could be a third person,” Donnelly says.

Donnelly explains only one thing (besides big profit) is of importance to the counterfeiter. “It’s not whether the medication works or not. It’s whether or not it looks like the product. They may use floor wax on it to give it a shine. They may use automobile paint to give it colour. They’ve used ink cartridges for colour. We’ve seen boric acid used as a dilutent to give the tablet its size and shape. One of the favourite things for making the tablets is sheet-rock.”

Donnelly’s team works together with local law enforcement to stop dozens of counterfeit operations each year they bust the dirty labs which are the polar opposite of the hygiene, sterile environments where the genuine article is produced.

“You have no idea how that drug’s been manufactured. You have no idea how it’s been stored,” Donnelly says.

In many cases, it is near impossible to distinguish a fake medication from its real counterpart, so agents use a device known as a TruScan. The device blasts a laser which analyses the drug’s chemical composition to determine authenticity.

“As you can see, it failed. So this is counterfeit. It’s counterfeit,” Donnelly says after scanning one of the Viagra pills.

However, not only was the pill fake, it gets worse. In one batch of counterfeits, the anti-inflammatory medication diclofenac was discovered to be mixed in, for seemingly no reason whatsoever.

“When you get something that’s contaminated with another drug, you have the potential for getting someone sick,” Donnelly warns.

New guidance recommends millions more to take statins

There could soon be millions more British patients being prescribed cholesterol-lowering statins such as atorvastatin or pravastatin to safeguard against heart attack and stroke, following the publication of new guidelines in the United States of who would benefit from taking statins; the first such guidance to be released in the US in a decade.

The updated guidelines are based upon the findings of a new study conducted over four years by the American Heart Association and American College of Cardiology, who decided to ‘think outside the box’ so to speak, as to what constitutes putting someone at a risk of heart attack and/ or stroke.

The researchers, unlike many of their peers who conduct similar studies, shifted their interests away from high cholesterol and instead utilised a formula to calculate risk and looked at a person’s age, gender, race, together with certain health factors like smoking.

“This guideline represents a departure from previous guidelines because it doesn’t focus on specific target levels of LDL, or bad cholesterol, although the definition of optimal LDL cholesterol has not changed,” Dr Neil Stone, author of the report, said in a statement.

Dr Stone added: “The likely impact of the recommendations is that more people who would benefit from statins are going to be on them.”

Dr Donald Lloyd-Jones, one of the experts who help to draft the new guidelines, said: “We’ve been undertreating people who need statin therapy. Statins lower cholesterol levels, but what they really target is overall cardiovascular risk.”

More African-Americans – a demographic usually at a higher risk of stroke – could be prescribed statins in accordance to the new guidelines.

Under the guidance, there would now be approximately 44% of men and 22% of women who would be deemed suitable for taking statins – or 33 million Americans.

This is in stark contrast to previous US guidelines that meant only 15% of adults in America were recommended for statin treatment, whereby patients had to have a target set to lower their cholesterol to. These numerical targets have now seemingly been abandoned.

In creating the guidelines, the panel analysed four particular groups who they believed to need statins more than most: patients currently with heart disease, people with LDL levels of 190 or higher due to genetic risk, adults aged between 40 and 75 with type 2 diabetes and older adults with a 10-year risk of heart disease in excess of 7.5%.

Those in the panel also stressed the importance of a “diet pattern” which includes fruit, vegetables and whole grains, with all adults engaging in moderate to vigorous exercise three to four times per week.

Many of the patents on statins have expired, with significantly cheaper generic statins now available. Crestor (rosuvastatin), a statin manufactured by AstraZeneca, still remains under patent however and in 2012 alone the drug had impressive sales of $8.3bn (£5.2bn).

Statins are actually the most commonly prescribed drugs in the UK, used by almost a tenth of the population. As cholesterol is still the primary factor in the process of prescribing statins, it is worth noting that NHS guidelines state that LDL cholesterol should not be higher than 3.0 and overall cholesterol no higher than 5.0.

South London stroke rates drop by 40% since 1995, statins credited

A new study has found that the incidence of strokes in a large area of South London has declined by more than a third during the 15 years between 1995 and 2010.

Researchers from King’s College in London say that the number of people suffering from strokes has fell by 39.5% in that time period in the area. Incidence of strokes was calculated at 247 per 100,000 people in 1995, however it was only 149.5 per 100,000 in 2010.

Approximately 152,000 people each year in the United Kingdom suffer from a stroke. There are two main types of stroke – ischaemic and haemorrhagic. The former accounts for a staggering 80% of all cases of stroke. An ischaemic stroke occurs when blood flow to the brain is prevented by either a blood clot or clump of fat. There is a high risk of a blood clot if your arteries have narrowed and clogged with fatty deposits; known as atherosclerosis. Major risk factors for atherosclerosis include smoking, high blood pressure, high cholesterol, obesity, diabetes and a family history of heart disease or stroke.

A haemorrhagic type of stroke is brought on due a weakened blood vessel supplying the brain rupturing and resulting in bleeding into the surrounding brain and brain damage. Two types of weakened blood vessels will typically cause a haemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs).

The researchers involved in the new study say the decline may be attributed to more people adopting a healthier lifestyle and the positive effects of cholesterol-lowering medications (statins), such as Lipitor (Atorvastatin) and Crestor (Rosuvastatin). Both drugs work to lower LDL, or “bad” cholesterol, and raise patients’ good HDL levels. It is estimated that statins are currently prescribed to an incredible 7 million in the United Kingdom – around a tenth of the population.

The team from King’s College looked at data extracted from the South London Stroke register, a database that covers an area with over 350,000 people in.

They found that rates of stroke incidence generally had fallen in men, women, white patients and those over the age of 45. However, similar declines in rates were not evident in those aged 15 to 44, or black patients, according to the researchers.

“We observed a higher prevalence of hypertension and diabetes mellitus in black patients compared with white patients in each of the four time periods in all age groups,” they commented.

“Other possible explanations for ethnic disparities include cultural differences in perceptions of health and the health care system, environmental exposures, genetic factors, socioeconomic status, and educational attainment.”

Professsor Graham MacGregor, chairman of charity Blood Pressure UK, said advances in medical knowledge had resulted in much more effective treatments being available for patients.

“We’ve got better blood pressure drugs and they are used more effectively. In the past GPs would prescribe one drug. We now know they work more effectively in combination, and they are often more acceptable to patients, with fewer side effects, so they take them and don’t leave them in the medicines cupboard. Statins cut the risk of stroke by 30 to 40 per cent so they have also played a part, but we need to do more.”

Dr Madina Kara, researcher at the Stroke Association, was clearly delighted with the findings from the study. She said: “It’s encouraging to see such a striking reduction in the number of people having a stroke in the past 16 years. Public health campaigns around the risk factors for stroke, such as high blood pressure and smoking are helping people to take control of their health and reduce their risk of stroke. This reduction, however, is not being mirrored in those under 45 years old, and the black population, where the incidence of stroke remains high.”

She also explained why certain sectors of the population could be more at risk compared to others. “We know that the African-Caribbean community are at greater risk of sickle cell disease, diabetes and high blood pressure – conditions that can lead to stroke. This means they are twice as likely to have a stroke compared to the white population. In addition, haemorrhagic stroke, caused by bleeding within or around the brain, is more common in younger adults,” she said.

Dr Kara added: “Stroke changes lives in an instant and can have a devastating physical and emotional impact on not only the stroke survivor, but their family and carers as well. To help reduce stroke across the whole population, we all need to take steps to reduce our risk.”

Self-injectable cholesterol drug alirocumab is in the pipeline

Pharmaceutical giants Sanofi and Regeneron have developed a potentially ground-breaking new cholesterol drug – currently named ‘alirocumab’ – which analysts are predicting could be a massive sensation and bring in billions of dollars for its creators if the late-stage trials prove successful.

The new cholesterol-lowering drug is self-injectable and belongs to a class of biotech medicines named PCSK9 inhibitors, providing a different method of clearing the fatty deposits that can cause clogging within the arterial walls leading the way to a high risk of poor health, heart disease, strokes and other health complications.

Bad cholesterol, commonly referred to as “low density lipoprotein,” is one of the primary factors behind clogged arteries. If your body is generating sufficient amounts of good cholesterol, or “high density lipoprotein,” this helps the bad cholesterol to be cleared from the arterial walls and subsequently removed from the bloodstream via the liver. However, if you are low on good cholesterol, levels of bad cholesterol will rise and result in clogging in the arterial walls.

Health experts believe that PCSK9 inhibitors could be the biggest breakthrough in the fight against heart disease in two decades, since statins such as Lipitor, Crestor and Zocor have emerged.

Alirocumab contains man-made antibodies that target a particular protein which stops the body from getting rid of the bad LDL cholesterol from the bloodstream. They differ from the statins as statins actually prevent the liver’s production of LDL cholesterol.

Results from the new drug tested in a 100-patient trial are imminent and Sanofi are hopeful it may reach the market in two years’ time. Unfortunately, success will probably hinder on the results of more long-term clinical studies comprising on thousands of patients – and more reliable and trusted results will probably not be available for another five years from such studies.

Following tests in the initial Phase III study, alirocumab was found to reduce levels of LDL cholesterol by up to an incredible 72% and it is now being pitted against Merck’s Zetia, which has been shown to lower LDL cholesterol levels by around 19-24%.

Alirocumab is likely be prescribed to those with genetically-high cholesterol levels, patients deemed ‘high risk’ and who are not reaching cholesterol targets on whichever statin they are taking, and patients who could have a low tolerance to statins.

Speaking at a conference earlier this month, Sanofi’s CEO Chris Viehbacher said the French drugmaker may consider doubling its stake in Regeneron, clearing having faith in the ability and success of alirocumab.

He commented: “When you look at the number of patients who are willing to inject themselves daily for diabetes, and you know a lot of those patients are also going to be in your patient population for PCSK9, I actually think that the injectable part is not going to be as big a barrier as people think. I think it is going to be a paradigm shift for healthcare and a potentially huge opportunity for us.”

Unfortunately, the need for alirocumab to be injected and the high costs involved will deter many and pricing will be a major issue in the UK as the NHS already facing numerous deficit-cutting measures. Certainly the new drug, if and when it eventually hits the market, will be substantially more expensive than statins – currently prescribed to around 7 million people in the UK.

Cholesterol-lowering statins may help to slow the aging process

Statins are one of the most studied classifications of medications in the pharmaceutical industry as researchers gradually uncover the fantastic depths of their potential.

As well as their primary purpose of lowering low-density lipoprotein (LDL) cholesterol aka. ‘bad cholesterol’ and thus decreasing the risk of cardiovascular disease, statins such as Lipitor (Atorvastatin) and Crestor (Rosuvastatin) have even remarkably been linked with aiding the symptoms of erectile dysfunction, decreasing the risk of liver cancer, and are even being explored in the treatment of asthma.

However, the list of potential benefits of statins has one new addition, according to the findings of research published in September’s publication of The FASEB Journal.

A study conducted in Italy shows that statins may slow down the rate at which telomeres reduce in size – an important factor in our natural aging process. Therefore, this could pave the way for statins forming the basis of a revolutionary anti-ageing treatment.

“By telomerase activation, statins may represent a new molecular switch able to slow down senescent cells in our tissues and be able to lead healthy lifespan extension,” said Giuseppe Paolisso, M.D., Ph.D., a researcher involved in the work from the Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine at Second University of Naples in Naples, Italy.

Paolisso and colleagues divided their study participants into two groups; one group on statin therapy and a second, control group, who were not taking statins. Following an analysis of telomerase activity for both groups, those taking statins were found to have a higher activity within their white blood cells and thus less telomeres shortening in comparison to the control group. This shows the importance of telomerase activation in slowing down the development of many short telomeres.

You’d be forgiven for not knowing what a ‘telomere’ actually is though. The ends of our chromosomes are comprised of cells containing a DNA sequence that helps to prevent the threads of DNA from unravelling; a fraying effect as a consequence of cell division. These ends are known as telomeres. Due to the fact they prevent chromosome ends from fraying and sticking to each other, telomeres are often compared to the plastic tips on shoelaces.

The importance of telomeres is because each time a cell divides, the telomeres get shorter. If they shorten too much, the cell becomes unable to divide and becomes inactive, ‘senescent’ or simply dies. This has been linked to aging, cancer and an increased risk of death.

NHS prescriptions surge to 1 billion in a single year

An incredible milestone has been reached, with a record 1 billion NHS prescriptions dispensed within a single year for the first time ever in England, according to new statistics compiled by the Health and Social Care Information Centre (HSCIC).

The figure was met during 2012 across England and represents a 62% surge from the previous decade, when 383.5 million items were dispensed. The billion prescriptions dispensed is the equivalent of 2.7 million items each a day, or over 1,900 a minute.

Other figures in a report released by the HSCIC show that on average the NHS dispensed 18.7 items per person in 2012, whilst in 2002 it was just 12.4 per person. Moreover, the net cost per item has dropped from £11.10 in 2002 to £8.50 in 2012.

It is believed that an increasingly large and aging population are behind the increase in prescriptions as well as more patents beginning to expire and inexpensive generic alternatives becoming available.
For example, the net cost of the cholesterol-boosting medication atorvastatin (marketed as Lipitor by U.S. Pharmaceutical giant Pfizer) dramatically dropped during 2011 and 2012 from £310.9 million to £166.6 million.

Since then, Pfizer have also lost the UK patent for Viagra, meaning certain other pharmaceutical companies are able to produce an erectile dysfunction medication that contains Viagra’s active ingredient sildenafil citrate, at a significantly lower cost to the patient. Sildenafil Teva and Sildenafil Actavis are two such examples to emerge since the UK Viagra patent ended on June 21.

In what could be a testament to Britain’s burgeoning obesity crisis, for the sixth consecutive year diabetes prescriptions were the biggest cost by treatment area, costing £768 million in 2012 – representing a 2.2% (£16 million) increase from 2011.

Since 1996 the number of people diagnosed with diabetes in the UK has risen from 1.4 million to 2.9 million, of which an estimated 90% are believed to have type 2, which can be caused by either being overweight or obese. Health experts predict that by 2025 5 million people in the UK will have diabetes.

Commenting on the prescription increase, HSCIC chairman Kingsley Manning said: “For the first time, one billion prescription medicines have been dispensed to our communities in just one year. This figure reflects a continuing upward trend in prescription numbers, which is in contrast to a recent fall in total net cost. Total costs have fallen for the second year running and are now at 2009 levels. Our report shows that, while people on average now receive more prescription items, the cost of these per head has dropped in the last two years.”

However, the figures also demonstrate a ‘notable’ rise in the number of antibiotics prescribed – which is causing huge concern. The Government’s chief medical officer has previously spoken of fear that the body’s increasing resistance to antibiotics is one of the biggest threats to modern health.

Professor Dame Sally Davies said many drugs are unnecessarily dished out for mild infections or illnesses and this helping to create a resistance to them, warning that even routine operations such as hip replacements could become fatal if we lose the ability to fight off infection.

Cholesterol-lowering statins may also lower Parkinson’s risk

New research suggests that cholesterol-lowering statins may play a pivotal role in the development of new treatment for the progressive neurological disorder Parkinson’s disease.

Parkinson’s is complex condition and different people may experience a wide variety of different symptoms. Common symptoms however include: tremors (shaking), rigidity (stiffness) and a slowness of physical movements (known as bradykinesia).

Statins such as atorvastatin (Lipitor) and rosuvastatin (Crestor) are currently taken by around 7 million people in Britain, and work by decreasing rates of low-density lipoprotein (LDL) cholesterol (‘bad cholesterol’) by reducing the production of LDL cholesterol inside the liver. It is dangerous to have high rates of LDL cholesterol as this causes the arteries to become narrower and harder (atherosclerosis), causing a higher risk of heart attack, stroke and coronary heart disease.

The history of statins can be traced back 42 years to 1971 when a Japanese biochemist named Akira Endo, working at pharmaceutical company Sankyo, pioneered the search for a drug that would help to lower-cholesterol.

Since 1971, statins have soared in popularity and scientists have unearthed other potential uses for the class of drugs, aside from their cholesterol benefits – which last year were shown to have reduced heart attack deaths by half.

For instance, studies have linked statins to helping treat erectile dysfunction, liver cancer, and have even been explored as beneficial for asthma patients.

The new study into statins comes from Taiwanese research published online yesterday in the journal Neurology.

After analysis of almost 44,000 patients, scientists at the National Taiwan University Hospital discovered that taking those patients who stopped taking fat-soluble statins such as simvastatin (Zocor) or atorvastatin (Lipitor) were approximately 58% more at risk of developing Parkinson’s in comparison to patients who carried on taking the statins.

Unlike water-soluble statins, it is generally believed that fat-soluble statins pass through the blood-brain barrier, helping to reduce inflammation and could even alter dopamine pathways in the brain that are associated with Parkinson’s.

The Taiwanese national health insurance program has forbidden doctors to prescribe statins to a patient once their target cholesterol level has been reached.

This policy will be scrapped Aug. 1, but has made it possible for this study to compare the potential difference in Parkinson’s risk in patients who stopped taking statins against those still taking them.

“This policy allowed us to see whether there was any difference in the risk of Parkinson’s in people who stopped taking statins compared to the ones who kept taking them, ” said study author Dr Jou-Wei Lin, a cardiologist at National Taiwan University Hospital.  “We are more glad than surprised to demonstrate the relationship. Our analysis is observational…and further clinical trials targeting the association between statin use and Parkinson’s disease are still needed.”

Dr Kieran Breen, from the charity Parkinson’s UK, however warned people who suffer with Parkinson’s should never treat themselves with statin medication unless they have been advised to do so by their own GP.

Work-related stress could be dangerous for our cholesterol

If you are sitting down to read this whilst in a job you hate – now may be the time to reach for that stress ball.

According to Spanish researchers, stress at the workplace cam change the way our body processes fat, increase ‘bad’ LDL cholesterol levels, which then raises the risk of cardiovascular problems such as heart attack or stroke.  This disorder that causes the levels of fats and lipoproteins in the blood to be altered is known as ‘dyslipidemia’.

Published in the Scandinavian Journal of Public Health, the study was conducted by researchers from Ibermutuamur – a mutual insurance company specialising in work-related accidents and occupational illnesses – working with experts from the Virgen de la Victoria Hospital at Malaga and the Santiago de Compostela University.

There has long been an established connection between stressful jobs and an increased risk of coronary disease. Reasons for this are believed to be that stress makes us more likely to eat more unhealthy foods, smoke and drink alcohol.

In addition, data emanating from previous studies have suggested that stress could have an impact of levels of lipids in the blood by hindering the body’s metabolism. Unfortunately these studies included a relatively low sample size and sometimes demonstrated mixed results.

A strength of the study conducted in Spain is the fact it comprised of over 90,000 people. Ibermutuamur have annual medical check-ups and an incredible 430,000 people were assessed between 2005 and 2007 alone. Of these, a study questionnaire was distributed to over 100,000 randomly selected individuals and 91,593 responded. Participants were asked: “During the last year, have you frequently felt that you cannot cope with your usual job?” Those who replied ‘yes’ were deemed to have stress at work.

There were also 11 questions regarding any possible anxiety and depression symptoms, for example: “Have you felt keyed up, on edge?” and “Have you had difficulty relaxing?”

However, and somewhat strangely, diet was not taken into account in the questionnaire. Having a diet high in saturated fat can affect cholesterol levels. Some of the foods particularly bad in this aspect include: hard cheese, cream, lard, butter, cakes, biscuits, and sausages. It may well be that stress at the workplace leads people to opting for foods which are poor nutritionally and it is their diet responsible for an increase in bad cholesterol, and not the stress itself.

Nonetheless, the results from the study are intriguing and perhaps should encourage employers to try and minimise stress for their employees and create a positive work environment. In addition, Medical Specialists Pharmacy urge all readers to take a look at our article published last year for National Cholesterol Week in which we offered many tips to improve heart health and avoid high cholesterol.

Carlos Catalina, clinical psychologist and an expert in work-related stress at Ibermutuamur, said in a statement: “The workers who stated that they had experienced difficulties in dealing with their job during the previous 12 months – 8.7 percent – had a higher risk of suffering from dyslipidemia – a lipoproteins’ metabolic disorder that can manifest itself in an increase in total cholesterol, low-density lipoproteins, the ‘bad,’ cholesterol and triglyceride levels, in addition to a drop in high-density lipoproteins, the ‘good’ cholesterol. One of the mechanisms that could explain the relationship between stress and cardiovascular risk could be the changes in our lipid profile, which means higher rates of atheromatous plaque accumulation of the arteries.”

If you want to improve your cholesterol levels, Medical Specialists Pharmacy can help. ‘Crestor’ (Rosuvastatin) and ‘Lipitor’ (Atorvastatin) are prescription-only treatments that belong to a group of cholesterol-lowering medicines called statins. Along with a healthy low-fat diet, they lower ‘bad’ cholesterol (LDL-C), increase ‘good’ cholesterol (HDL-C), as well as slowing the progression of atherosclerosis in adults with high cholesterol. We are pleased to inform our patients that we also offer legal generic Atorvastatin, with prices from as little as just £11.25 per pack.

Statins may help to combat Erectile Dysfunction

Cholesterol-busting statins such as Crestor (Rosuvastatin) and Lipitor (Atorvastatin) are currently prescribed to nearly a tenth (7 million) of the population in the United Kingdom with high cholesterol; however could they also be used as a treatment for the millions of men around the world who suffer from erectile dysfunction (ED)?

Statins are inexpensive with the pills costing around the equivalent of just 40p per day. For high cholesterol they work by increasing good/protective cholesterol (HDL) and lowering bad cholesterol (LDL) and triglycerides. The higher your cholesterol level, the bigger the risk you have of suffering from a stroke or heart disease and thus increasing the overall risk of having a heart attack due to your arteries being clogged up with the fat-like substance cholesterol.

ED, also known as male impotence, is a common condition that affects  about four in ten men over the age of 40 and around one in ten men across the UK suffer with the problem at some point in their life. Revolutionary medications to treat ED such as Viagra, Cialis and Levitra have dramatically managed to help the situation for millions of men in the previous decade. Unfortunately there are some men who take them and see little or no improvement. Erection problems can severely impact a man’s self-esteem and even can cause stress that damages his health and relationship with his partner.

Past research has highlighted the possibility of erectile dysfunction being a precursor for heart disease. Therefore, researchers at Tanta University in Egypt decided to conduct a study into statins and ED. They recruited 60 men suffering with erectile problems – all of whom had not responded to Viagra.

The men were separated into three groups, being given 80mg of atorvastatin (Lipitor) each day or a vitamin E supplement or a placebo. Vitamin E was chosen as it is widely believed to also help men in the bedroom by aiding blood flow to the groin.

Any possible improvements in the men’s ability to achieve and maintain an erection were monitored after six weeks.

The study’s findings are explained in the International Journal of Impotence Research, and show those men who experienced the most improvement with their erectile problems were those taking a statin every day. The men were analysed by doctors using a 25-point scale known as the International Index of Erectile Dysfunction. The statin atorvastatin helped to achieve an average increase of score by 53% on the index.

The researchers believe the atorvastatin helps to increase the generation of nitric oxide. This causes blood vessel walls to relax and results in much better blood flow which in the pelvic region, would lead to improved erections.

Dr David Edwards, a GP who runs a male sexual health clinic at the White House Surgery in Chipping Norton, Oxfordshire, said the findings were ‘interesting’, commenting: “A lot of men stop taking them because the data sheet lists erectile dysfunction as one of the potential side-effects. But there is increasing evidence that a high dose of statins can improve vascular blood flow, which might help some men.”

Chemical contained red meat may cause heart damage

A study carried out by researchers from Cleveland Clinic in Ohio, US, has found that the chemical L-carnitine can increase the risk of suffering from heart problems. Saturated fat and the manufacturing process involved with how meat is preserved are widely believed to be related to heart problems, but many health experts think there is more to it. 

Lead researcher of the new study, Dr Stanley Hazen, commented: “The cholesterol and saturated fat content of lean red meat is not that high, there’s something else contributing to increases in cardiovascular risk.”

L-carnitine is a nutrient which is contained in red meat, dairy products and some dietary supplements.  The study, published in the journal Nature Medicine, showed that the carnitine contained red meat was broken down by naturally occurring bacteria in the gut. 

However, this later resulted in higher levels of cholesterol and an increased risk of heart disease as the resulting broken down product - trimethylamine-N-oxide (TMAO), is known to speed up the build-up of plaque in arteries and cause them to harden (atherosclerosis) – a main cause of heart disease.

Part of the researchers’ investigations was conducted in humans, whilst other testing was carried out with mice. Studies involving animals can be sometimes difficult to interpret, and some degree of caution should be shown when generalising the findings to humans.

For the study, 77 healthy volunteers were administered a supplement of L-carnitine. Of this total, 26 were classified as vegans or vegetarians. Some of the meat-eaters in the group were told to eat an eight-ounce sirloin steak - this works out at around 180mg of L-carnitine.

Researchers then gave antibiotics to the participants for a one week period. These prevented bacteria in their gut from converting L-carnitine into TMAO. After this, the 77 people again were given L-carnitine. Tests were conducted on blood and urine at the beginning of the study and up to three weeks following L-carnitine being given. Some of the people also had their faeces analysed.

In addition, L-carnitine levels were checked in the blood of 2,595 other people, all of whom had attended a heart check-up. The researchers thought this would be an effective measure of assessing a potential link with L-carnitine levels and known cardiovascular disease, or risk of a cardiovascular event (i.e. a heart attack or stroke).

Finally, plaque levels were studied in the arteries of mice and this was done by comparing mice fed normally against a group of mice fed L-carnitine, for a 10 week period. Some of these mice were given antibiotics beforehand. 

The main findings were:

. Meat-eaters produced more TMAO compared to vegans or vegetarians following L-carnitine ingestion.

. A ‘significant’ link was found between L-carnitine concentrations and risk of cardiovascular event in those having heart check-ups. However this was only for those with a high TMAO concentration. Researchers state they believe this shows that TMAO, rather than L-carnitine, is the main factor of this link.

. A study of the faeces showed L-carnitine affected how much TMAO was in the blood.

. Mice given L-carnitine, were at a double risk of developing a plaque build-up in their arterial walls, - but only when they had their normal gut bacteria. When the animals were given antibiotics to clear the gut, L-carnitine did not cause the same arterial wall build-up.

Dr Hazen says that TMAO can be underestimated, and said: “It may be a waste product but it is significantly influencing cholesterol metabolism and the net effect leads to an accumulation of cholesterol. The findings support the idea that less red meat is better. I used to have red meat five days out of seven, now I have cut it way back to less than once every two weeks or so.”

A Mediterranean diet can decrease heart attack risk

Researchers claim that by adhering to a healthy Mediterranean diet, this is almost as good for your heart as statins in reducing the risk of suffering from a heart attack or stroke. The news emerges coincidentally as we approach the end of the ‘Rock up in Red’ campaign for National Heart Month, of which Medical Specialists Pharmacy are proud supporters of.

Cholesterol-busting statins such as Crestor (Rosuvastatin) and Lipitor (Atorvastatin) are currently prescribed to nearly a tenth (7 million) of the UK population and function by raising good/protective cholesterol (HDL) and lowering bad cholesterol (LDL) and triglycerides. The higher your cholesterol level, the bigger risk there is of suffering from a heart attack and stroke due to your arteries being clogged up with the fat-like substance known as cholesterol.

However, Spanish researchers led by Prof Ramon Estruch, a professor of medicine at Barcelona University, believe that consuming a Mediterranean diet comprising of plenty lot of fruit, vegetables, fish and wine, and only small amounts of red meat or dairy products, can provide some degree of defence against heart problems.

Many have previously acknowledged the fact that people from Mediterranean countries are more inclined to have lower levels of heart disease though there has been uncertainty if this was due to hereditary factors, or linked to diet and lifestyle.

For the study, the Spanish academics tracked 7,447 people during the years of 2003 and 2009 – consisting of men aged 55 to 88 and women aged 60 to 80. None of the participants had any kind of cardiovascular disease at the beginning of the study. However, they were all at risk due to having type 2 diabetes or were at risk due to having three things from a list of health problems. These were: smoking, high blood pressure, high levels of bad cholesterol, low levels of healthy cholesterol, overweight or there being family history of coronary heart disease.

The participants were assigned into one of three groups; two of which were instructed to eat a Mediterranean diet – one supplemented with four table spoons of extra-virgin olive oil and the other with about one ounce of nuts (walnuts, almonds or hazelnuts). The third group were instead told to stick to a diet that included low-fat dairy products, grains and fruits and vegetables.

Following an average of 4.8 years assessment, 228 had either suffered a heart attack or stroke or died of heart-related problems. Of this total, 96 were in the olive oil group (3.4% of participants), 83 in the group eating plenty of nuts (3.4%) and 109 in the low-fat group (4.4%). This equates to a 30% decline in risk for those on the Mediterranean diets compared with the low fat diet.

Researchers say that important elements from the diets that boosted health included moderate consumption of ethanol – derived from the wine, low consumption of meat, and high intake of vegetables, fruit, nuts, legumes, fish and olive oil. In fact they were so impressed with their study findings that they began adopting a Mediterranean diet themselves.

The authors conclude: “The results of our trial might explain, in part, the lower cardiovascular mortality in Mediterranean countries than in northern Europe or the United States.”

Although not involved with the study, Dr Mike Knapton, associate medical director of the British Heart Foundation, commented on its findings, and advised against anybody deciding to forsake their prescribed statins in favour of merely a change in diet. He said: “This large long-term study shows that eating a Mediterranean diet is associated with heart health benefits, including reductions in heart attack, stroke and deaths from cardiovascular disease. While these findings aren’t new they add to our knowledge and confidence that a Mediterranean diet can help cut down your cardiovascular risk. A well-balanced diet low in salt, saturated fat and sugar is a vital part of a healthy lifestyle. That said, a Mediterranean diet should not replace your prescribed medication.”

Small salt reduction could save thousands of lives

UK Health experts say that thousands of deaths could be prevented every year if consumers were more aware of exactly how much salt is in the food they are eating in comparison against their daily recommended limits.

British health professionals voiced their concerns about the UK’s ignorance to the dangers of too much salt after the publication of a damning U.S.-based study that linked the high salt content in processed foods to the obesity crisis in America.

British GP Ian Campbell, medical director of charity Weight Concern, said: “The same problems exist in the UK, with heart disease a well-recognised consequence of excessive salt. Greater awareness of the harm salt can do might help people choose to reduce their intake. Processed food is high in fat, sugar and salt. Food manufacturers have significantly reduced salt content, but it’s still too high. The average person has no idea of the quantities of salt in their diet – simply because they’re not adding it, the manufacturers are. People need to be aware the food we eat does affect our health directly. If you don’t know what’s in the food you are about to eat, ask.”

High levels of salt in a person’s diet can raise your blood pressure and hypertension (high blood pressure) means you are at an increased risk of health problems such as heart disease and stroke. Doctors are adamant that if consumers paid more attention to food labels, an incredible 25,000 lives could be saved each year.

Unfortunately though, many Brits are still unaware of theirs or their children’s daily recommended maximum intake, or even any rough idea of how much salt they are currently taking in.

According to health officials, if the average salt intake was reduced by merely a single gram, this could save 6,000 lives and £1.5billion annually. If the average consumption however dropped by four grams, approximately 25,000 deaths could be averted each year. British Heart Foundation statistics say that on average, men consume around 9.7g of salt a day and women fare a little better and average 7.7g – but still way above the recommended limit.

Dr. Campbell added: “Salt is a big problem in the UK too. It’s a silent killer. Over time consuming too much of it increases the risk of high blood pressure, which can lead to heart attacks and strokes. About 80 per cent of our salt intake comes from processed foods, so it can be difficult to avoid. Many people are unaware of where salt is hidden, such as bread, soups, ready meals, even breakfast cereals and mayonnaise. The Government approach has been to encourage food manufacturers to modify the amount of salt in their products. There has been a reduction but it is taking too long. The Food Standards Agency should consider setting mandatory maximum levels for salt.”

The recommended daily salt intake for adults has been 6g for many years, (around one full teaspoon), although the World Health Organization have spoken many times in recent years stating that at the very most, 5g should be the maximum intake each day.  However, current NHS guidance still sets the current daily limits to:

. 1 to 3 years: 2g salt a day (0.8g sodium).
. 4 to 6 years: 3g salt a day (1.2g sodium).
. 7 to 10 years: 5g salt a day (2g sodium).
. 11 years and over: 6g salt a day (2.4g sodium).

One of the biggest factors why people suffer with heart disease or stroke is because of high cholesterol. Salt itself does not contribute to high cholesterol levels, but consuming too much salt can cause high blood pressure that in turn is attributed to heart disease and stroke. Therefore, it is worth paying attention to the salt levels in your food.

To maintain healthy cholesterol levels you can also make other positive lifestyle changes to reduce risk factors, including: quitting smoking, lose weight if you are overweight, and limit the fat in your diet. All these will benefit blood pressure as well as cholesterol. Medication such as statins may be required if dietary alterations alone are not enough to have an effect, and for suitable patients they are obtainable from Medical Specialists Pharmacy at low prices. For more information about Crestor (rosuvastatin), Lipitor (atorvastatin), and Generic Atorvastatin, visit the Health and Lifestyle area of the Medical Specialists website.

A vegetarian diet can boost blood pressure and cholesterol

A Cancer Research UK and the UK Medical Research Council-funded study featured in American Journal of Clinical Nutrition suggests that those who adhere to a vegetarian diet and ditch meat and fish will see major health benefits over their meat-eating peers.

The findings of what is the largest study of its kind, could persuade some people to give-up meat in favour of veg and comes ironically only weeks after the Tesco horse meat scandal where some of their own-branded beef burgers were found to contain as much as 29% horse meat.

Scientists at the University of Oxford analysed 44,561 people in England and Scotland, recruiting participants over the age of 20 during 1993 to 1997. They specifically wanted vegetarians and vegans in the study to look at associations between nutrition and general health in contrast to the general UK population.

All participants were required to fill out a food-frequency questionnaire that quizzed them on what food they ate over the previous year, in addition to asking them about exercise, smoking habits and alcohol consumption. The researchers classified people as either non-vegetarian if they said they had eaten any meat or fish, or as vegetarian if they reported eating no meat or fish. For study purposes, vegetarians and vegans were categorised together (about 15,100 in total).

Over the course of an average 11.6 years of follow-ups, there were 1,235 cases of ischaemic heart disease (IHD). From this number, 169 people in the study had died as a result of heart disease and there were 1,066 recorded hospital admissions.

After taking into account factors such as age, gender, physical activity, smoking, alcohol intake, education and social background, it was calculated that being a vegetarian can decrease the risk of death or hospital admission from heart disease by a staggering 32%. Amazingly, a reduced risk was evident in both continuous vegetarians and in those who had begun eating meat at the five year follow-up.

If that wasn’t enough of a persuader to ditch the meat, vegetarians were also found to have lower levels of ‘bad’ cholesterol in their blood and a lower systolic blood pressure reading. Moreover, they were typically more slender with a lower body mass index (BMI) than the meat eaters, and had a reduced risk of developing diabetes.

Dr Francesca Crowe, author of the study at the Cancer Epidemiology Unit at the University of Oxford, said: “Most of the difference in risk is probably caused by effects on cholesterol and blood pressure, and shows the important role of diet in the prevention of heart disease.”
Co-author Professor Tim Key, deputy director of the Cancer Epidemiology Unit at the University of Oxford, added: “The results clearly show the risk of heart disease in vegetarians is about a third lower than in non-vegetarians.”

Red meat – particularly processed meat – comprises of numerous ingredients that have been regular attributed to increased risk of chronic diseases including bowel cancer. Such ingredients include heme iron, saturated fat, sodium, nitrites and certain carcinogens that are formed during the cooking process. At least by hitting the daily recommended intake of five portions of fruit and veg means that people can benefit from their antioxidant properties that work at reducing cholesterol, control blood glucose levels and reduce the risk of many types of cancer.

Cardiovascular disease is responsible for the largest number of deaths in the developed world. According to World Health Organisation statistics, it claimed 17.3 million lives in 2008 worldwide, with 6.2 million of these from strokes. A famous figure who almost succumbed to heart disease was former U.S. President Bill Clinton, once notorious for his strong penchant for hamburgers; he was required to have a coronary bypass operation in 2004 and is now leads a much better lifestyle.

As highlighted earlier, high cholesterol is a primary contributor for heart disease. However, Medical Specialists Pharmacy provides online consultations for patients with high cholesterol and with our help you can reduce the risk of developing heart problems. For suitable patients our in-house doctors can prescribe statin medication (Lipitor and Crestor), and our in house pharmacists can dispense to patients within 24 hours. We also dispense statins for patients who can provide a private prescription, and in 2012 we introduced the legally available generic Atorvastatin at much lower prices for suitable patients.