Statins could shield an unborn baby from the mother’s stress

Cholesterol-boosting statins could be used to help protect unborn babies from being impacted by their mother’s stress and thus reducing the risk of that baby growing up with health problems later in their life.

Statins are the most commonly prescribed treatment in the United Kingdom, taken by approximately anywhere between 5 and 10 million people, and estimated to cost the NHS around £500 million a year. They are usually prescribed to lower the patient’s high cholesterol levels, but scientists now believe they may also help protect the hearts of babies in the womb.

Research conducted at Edinburgh University discovered that statins helped counteract the negative effects brought on by stress hormones on foetal growth and heart development in mice.
Those involved in the research into the drugs, claim that the therapy may decrease the chances of babies being born underweight, and lower their risk of suffering with health problems in later life, such as heart disease.

Although the findings emanated from a study of mice, this may now prompt further analysis into looking at the long-term effects of statins during a woman’s pregnancy. However, researchers say the drugs are currently already sometimes given to pregnant women and therefore should be OK for clinical trials.

Professor Megan Holmes, from the University of Edinburgh, said: “These are very exciting results suggesting that there may finally be a potential therapy for women whose placenta is unable to maintain the normal growth of her baby.

“At present there is no treatment and babies may be born prematurely or small, and will be at greater risk of developing cardiovascular disease, diabetes and even psychiatric disorders later in life.
“Although more work needs to be done to show statins are safe in human pregnancy, these results show a new way forward for the major unmet need of foetal growth retardation.”

Previous studies have shown babies are typically born under what is considered a ‘normal’ weight, following exposure to high levels of stress hormones within the womb, and have a much higher risk of heart disease as they get older.

Usually, an unborn baby gets protection from a key enzyme generated the placenta. The enzyme helps to destroy the stress hormones, reducing the quantity of active hormones that can get to the baby’s blood supply.

If the mother is experiencing high levels of stress, the placenta then produces less of the enzyme and the baby’s protection is reduced.

Therefore, the researchers involved in the latest study decided to analyse mice that are unable to produce the enzyme as a model of maternal stress. It was discovered that stress hormones prevent the placenta from developing regular blood vessels, hindering the blood supply to the foetus.

This stops the growing foetus from reaching a full size as a result, negatively impacting the heart function too.

However, researchers found that by treating the mother with the statin Pravastatin, actually managed to trigger the production of a molecule called VEGF. This worked at stimulating the development of blood vessels in the placenta. Pravastatin is just one of numerous statins provided by Medical Specialists® Pharmacy, which also includes atorvastatin and rosuvastatin.

The study – published in the journal Proceedings of the National Academy of Sciences and was funded by the Wellcome Trust – found that by re-establishing the blood supply, the treatment helped to promote a regular development of the heart. In addition, the baby was able to grow to a healthy birthweight.

Professor Jeremy Pearson, associate medical director at the British Heart Foundation, said: “Low birthweight has been associated with maternal stress, and babies with low birthweights may be more prone to cardiovascular complications later in life.

“In this study the researchers have discovered that a drug called Pravastatin may counteract the consequences of increased levels of the stress hormone corticosterone within the placentas of mice.
“How Pravastatin counteracts the stress hormone is not yet understood, therefore more research is needed to see whether the drug will have the same effect in humans.”

Should more people be taking cholesterol-boosting statins?

Statins are the most commonly prescribed type of medicine within the UK, taken by millions of people to help lower their ‘bad’ low-density lipoprotein (LDL) cholesterol levels in the blood.

A large proportion of people may only be prescribed statins on the basis of their future risk though, for instance if there is a chance of the person developing cardiovascular disease, if there is a strong family history of cardiovascular disease, or determined by the person’s age.

However, experts have warned that this is simply excluding a great number of people who may benefit from taking statins, which include atorvastatin, rosuvastatin, pravastatin and more. The warnings came as part of a study published in the American Heart Association’s journal, Circulation.

Scientists based at the McGill University Health Centre (MUHC) in Montreal, Canada, argue that actually younger people with high cholesterol levels should be prescribed too. They estimated that there at least 9.5 million lower-risk, young people who would benefit from statins that aren’t taking them at the moment.

Dr George Thanassoulis, director of preventative and genomic cardiology at MUHC, said: “Targeting statin treatment to this group would prevent an additional 266,000 heart attacks and strokes over 10 years.”

In determining who they thought would receive health benefits from statin therapy, the scientists studied data from 2,134 participants of the National Health and Nutrition Examination Survey, a nationally-representative US cohort that spanned from 2005 to 2010.

The survey comprised of around 71.8 million Americans who were deemed eligible for statins. Those involved in the study then used a 10-year risk based approach, in addition to an individualised benefit approach, comparing the two different ways of looking at eligibility for statins.

Dr Thanassoulis commented: “Using a benefit-based approach, we identified 9.5 million lower-risk Americans not currently eligible for statin treatment, who had the same or greater expected benefit from statins as higher-risk individuals.

“These individuals were lower-risk because they were younger but they also had higher levels of low-density lipoprotein cholesterol which we have known to be an important cause of heart disease.”
The study’s findings may lead to health professionals reconsidering who should be prescribed the cholesterol-boosting drugs, and possibly recommending that people previously thought of as too young to be at risk of a heart attack, should be eligible for them.

Dr Thanassoulis said: “Our analysis shows that they would benefit from treatment, even in the short term, and therefore should be eligible for statin treatment.”

The scientists involved in the study argue that this could help to prevent a large number of people suffering with cardiovascular disease in the future.

“For too many, the present approach starts too late; an earlier start will multiply the lives save,” Dr Thanassoulis added.

The next step for the team that undertook the study will be the creation of a web interface to enable other physicians to take advantage of the new calculation model, and hope their method will result in new guidelines being set on identifying people who could benefit from statins.

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.

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.”

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.

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.

How grapefruit can cause fatal drug interactions

Whether you eat the fruit or drink its juice, the large colourful citrus fruit grapefruit would not probably invoke many, if any, concerns amongst the majority of people. For starters, its botanical name is ‘fruits of paradise’, which would automatically hint that it is loaded with a wide range of health boosts. Indeed this is true; grapefruit is incredibly rich in Vitamin C. So much so that just half of a grapefruit provides 46.86 mg, (78.1% of the recommended daily intake). The Vitamin C in grapefruit helps to maintain a healthy immune system, reduce symptoms of the common cold, and can also reduce the severity of inflammatory conditions such as asthma, rheumatoid arthritis and osteoarthritis.

If that wasn’t enough, grapefruit contains chemical compounds called limonoids, which decrease the risk of death from cancers such as breast, stomach and pancreatic, and the fruit lowers the chance of death from heart attack or stroke. This is partly because grapefruit is highly effective at lowering blood levels of LDL (‘bad’) cholesterol, with red grapefruit lowering triglycerides as well. It lowers the bad cholesterol because it contains a soluble fibre known as ‘pectin’ which has been shown in studies to slow down the progression of atherosclerosis; a hardening of the arteries that can occur for many reasons including high cholesterol.

Cholesterol is where a major concern arises in regards to grapefruit. For those suffering with high cholesterol, the majority are prescribed statin medication such as Rosuvastatin (Crestor), Atorvastatin (Lipitor), Lovastatin (Mevacor) and Simvastatin (Zocor). You may not be aware but statins and grapefruit do not mix! Although Crestor is widely thought to be safe, grapefruit can make the active ingredients in Lipitor, Mevacor and Zocor more potent, a combination that could prove fatal.

This happens as grapefruit contains high levels of the flavanoid naringin, which interferes with enzymes in the body such as cytochrome P-450 and P-glycoprotein. Both of these enzymes work at breaking down drugs like statins and many others, into more usable chemicals, which are subsequently moved around the body. However, the compounds in grapefruit cause a drug interaction by inhibiting this metabolism process of the medications in the digestive system, resulting in a build-up of the drug’s ingredient in the bloodstream and causing a toxic poisoning.

The dangerous level of statins in the body may cause liver damage or a rare disease associated with statins, called ‘rhabdomyolysis’. This condition is the breakdown of muscle fibre that then triggers the release of muscle fibre contents called myoglobin into the bloodstream which is followed by kidney failure (where waste and urine cannot be removed) and severe muscle damage.

It is not just grapefruit you need to consider though when taking pharmaceutical drugs. Pomelos and Seville oranges, a type of bitter orange sometimes used in marmalades and compotes, may also cause interactions with medicines.  Be warned that interactions can occur even if you eat or drink a small amount of these fruits and researchers are working to find other types of food that could dangerously react with particular medications.

If you are prescribed any medicines, not just statins, then you should immediately check with your own doctor to make sure that it is safe to consume grapefruit products or indeed any citrus fruits whilst also taking your medication. Your doctor could advise you to completely exclude any grapefruit product in your diet, lower your dose of medication if you are adamant about still having grapefruit in your diet, or possibly advise a different medication for you.
We have mainly discussed the certain statins that can have an adverse effect with grapefruit; however there are many other types of drugs that interact with the fruit. These include:

. Anti-anxiety – Buspirone (Buspar).
. Anti-arrhythmia – Amiodarone (Cordarone), Aronedarone (Multaq).
. Anti-depressant – Sertraline (Zoloft).
. Antihistamine – Fexofenadine (Allegra).
. Cough medicine – Dextromethorphan (Coricidin, Delsym, Dimetapp, NyQuil, Robitussin Vicks and other generic cough medicines).
. Erectile dysfunction – Sildenafil citrate (Viagra).
. High blood pressure – Felodipine (Plendil), Isradipine (DynaCirc), Nicardipine (Cardene), Nifedipine (Procardia), Nimodipine (Nimotop), Nisoldipine (Sular).