Dr Tan Ngiap Chuan, who led the study and is the director of research at SHP, said the findings could prompt doctors to prioritise starting or adjusting medications with their patients. "We usually focus on other lifestyle factors first. We may switch the order now."
In addition to statins, a new class of injectables have emerged in recent years. They provide an alternative for patients “who are unable to achieve their targeted cholesterol levels, who are statin intolerant, or unable to adhere to regular therapies”, said Prof Tan.
These include the PCSK9 inhibitors (such as evolocumab and alirocumab), which are injected once every two weeks. There are also the small interfering RNA or siRNA, which requires subcutaneous injection only once every six months. These siRNA include inclisiran, which was recently approved by Singapore’s Health Sciences Authority and the US Food and Drug Administration, said Prof Tan. “The injectables can be used in combination with oral medicines.” Unfortunately, the commonly prescribed statins have received bad press on social media, said Prof Tan, even though they have been “proven to be effective in preventing heart attacks, strokes and death – even among low-risk patients”. It has led patients to develop “unfounded fears” for statin-associated side effects, he said. Here, Prof Tan tackles some of the common misconceptions patients have about statins:
MISCONCEPTION 1: Doctors prescribe statins as a catch-all
(Photo: iStock/wutwhanfoto)
Statins are widely used as they satisfy two crucial functions in disease management: Preventing the onset of disease before it begins; and reducing the severity or impact of a disease if it already has by “halting its progress and preventing recurrences”, said Prof Tan. “Certainly, patients who are at low risk for heart attack and stroke will benefit less from taking statins,” he said. But “among medical experts, there is little debate on whether statins work in high-risk patients”. Having said that, statins aren’t prescribed indiscriminately. According to Prof Tan, patients are usually started on a course only if they satisfy any of these criteria: Atherosclerotic cardiovascular disease. This means the patient has pre-existing blockages in the heart, brain or any arteries in the body’s circulatory system. Diabetes mellitus. Especially those who have been living with diabetes for more than 10 years. High LDL cholesterol level. Higher than 190mg/dL (4.9mmol/L). As prevention. These are patients with no established cardiovascular disease but have multiple risk factors that increase their chances of developing it in the future.
MISCONCEPTION 2: Once you start on statins, you have to be on them for life
This is true, though. The cholesterol-lowering benefits conferred by statins will only continue for as long as you take the medicine, said Prof Tan. “The cardio-protective effect is lost when the statins are stopped.” You would have considered to have discontinued your medication if you stopped for more than a year. Perhaps the more pertinent question is: What are the effects of being on statins in the long run? “Studies have shown that statins are safe and well tolerated. They have been used for more than 30 years to lower cholesterol. In fact, statins work best when you take them for a long time,” said Prof Tan. Look at it as insurance for a longer life and to prevent heart attacks and strokes, he added.
MISCONCEPTION 3: Statins cause diabetes
(Photo: iStock/hinnapong)
Source: CNA/bk Source link
Storvas C®
Kegunaan:
Menurunkan tahap kolesterol LDL
Mengurangkan risiko serangan jantung dan angin ahmar (strok)
Cara pengambilan:
1-4 biji 1 kali sehari selepas makan pada waktu malam
Kesan sampingan:
Kesan sampingan yang biasa:
Cirit-birit (sehingga 14.1%)
Sakit sendi (sehingga 11.7%)
Sakit otot (sehingga 8.4%)
Hidung tersumbat atau bersin (sehingga 8.3%)
Sila beritahu doktor jika kesan sampingan tersebut berterusan atau bertambah teruk.
Kesan sampingan yang serius tetapi jarang berlaku:
Reaksi alahan ubat (ruam, bengkak mulut atau mata, sesak nafas)
Sakit otot yang tidak dapat dijelaskan atau lemah
Peningkatan enzim hati
Pendarahan otak
Sila beritahu doktor dengan segera jika mengalami kesan sampingan yang serius.
Ini bukanlah senarai lengkap kesan-kesan sampingan yang boleh berlaku. Sila hubungi doktor atau pegawai farmasi untuk maklumat lanjut.
Penggunaan jika mengandung:
Kategori X: Elakkan penggunaan – kajian telah menunjukkan kesan mudarat dan boleh menyebabkan kecacatan kepada janin
Penggunaan jika menyusukan anak:
Elakkan penyusuan – terdapat risiko kesan mudarat kepada bayi
Kontraindikasi:
Sejarah reaksi alahan terhadap ubat ini atau bahan dalam ubat ini
Penyakit hati
Peningkatan enzim hati secara berterusan tanpa sebab yang diketahui
Sila huAtorvastatin 20 mg Film-coated Tablets – (emc) bungi doktor atau pegawai farmasi anda untuk maklumat lanjut
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Brand:Storvas C® Usage:
Lowers LDL cholesterol levels
Reduces the risk of heart attack and stroke
How to take:
1-4 seeds 1 time a day after eating at night
Side effect:
Common side effects:
Diarrhea (up to 14.1%)
Joint pain (up to 11.7%)
Muscle pain (up to 8.4%)
Stuffy nose or sneezing (up to 8.3%)
Please tell your doctor if these side effects persist or worsen.
Serious but rare side effects:
Allergic drug reaction (rash, swelling of the mouth or eyes, shortness of breath)
Unexplained muscle pain or weakness
Increased liver enzymes
Brain hemorrhage
Please tell your doctor immediately if you experience any serious side effects.
This is not a complete list of possible side effects.
Please contact your doctor or pharmacist for more information.
Use if pregnant:
Category X: Avoid use – studies have shown harmful effects and may cause birth defects
Use if breastfeeding:
Avoid breastfeeding – there is a risk of harm to the baby
Contraindications:
History of allergic reactions to this drug or ingredients in this drug
Liver disease
Persistent elevation of liver enzymes for no known reason
Please contact your doctor or pharmacist for more informationJenama:
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Description
Atorvastatin is a cholesterol-lowering medicine. It works by blocking the action of an enzyme responsible for the production of cholesterol in the body. Thus, it helps in reducing blood cholesterol levels. It also prevents the risk of heart problems.
Atorvastatin may cause common side effects such as headache, nausea, diarrhoea/constipation, indigestion, muscle pain, stuffy nose, etc. Consult your doctor if these symptoms persist for a long time or if they become severe. Atorvastatin can be taken with or without food as instructed by your doctor. Take it at the same time every day to maintain a constant level of this medicine in your body. Do not skip a dose or discontinue the treatment without consulting your doctor.Atorvastatin is not recommended if you are allergic to it, or have liver problems. Inform your doctor if you have diabetes as this medicine may affect your blood sugar control. This medicine is not recommended for use if you are pregnant or are breastfeeding.
Understand Your Blood and Urine Test Results
Cholesterol
This
count comes from a blood test called a lipid profile. The healthy total
cholesterol level for adults is below 200 mg/dL. It’s the sum of two
types of fats: “bad” (LDL) and “good” (HDL) cholesterol. But even if
your number falls in the desirable range, you still can have too little
of the good kind and too much of the bad, which clogs your blood
vessels. Aim to keep your LDL cholesterol under 100 mg/dL and your HDL
above 60 mg/dL.
Triglycerides
Triglycerides can harden your arteries. High levels are linked to a higher risk of a host of heart problems, like strokes and heart attacks, as well as obesity and high blood pressure.
These readings are for healthy adults after 12 hours of fasting:
- Desirable: Less than 150 mg/dL (1.7 mmol/L)
- Borderline high: 150 to 199 mg/dL (1.7-2.2 mmol/L)
- High: 200 to 499 mg/dL (2.3-5.6 mmol/L)
Very high: Greater than 500 mg/dL (above 5.6 mmol/L)
Who Needs a Lipid Profile?
Everyone over 20 should get a full lipid panel every 4-6 years. Kids should have a full lipid profile once ages 9-11 and again ages 17-21. That’s partly because high cholesterol and triglycerides may lead to plaque buildup in children and teens. Your doctor may want testing more often if you’re at risk for heart disease or if you’re being treated for high cholesterol. Acceptable total cholesterol for most people under 19 is 170 mg/dL.
Blood Sugar Test
It’s also called a glucose test. High levels, or hyperglycemia, could be a sign of diabetes or prediabetes. If you’re healthy, yours should be less than 100 mg/dL after fasting. A reading of 126 mg/dL or higher means you have diabetes. With two other tests -- glucose tolerance and random blood sugar -- a level of 200 mg/dL or higher indicates diabetes. And too low blood sugar may damage your brain or cause other health problems.
A1c, or Hemoglobin A1c
This is a more complex way to gauge your blood sugar than with a blood glucose test. Your A1c gives you a longer-term view of your average blood sugar over 2-3 months. That matters because your glucose level can swing a lot throughout the day if you have diabetes. A1c calculates the percentage of red blood cells coated in sugar. A healthy level is usually below 5.7%. If you have diabetes, your doctor will recommend keeping it under 7%.
Urinalysis
Your pee can show you a lot about your health. Its color, pH level, and the presence of ketones, bacteria, and other substances can reveal diseases and other problems. A urinalysis is routine if you’re pregnant or having surgery. Other reasons for it include if your doctor suspects a urinary tract infection (UTI) or kidney disease. If your urinalysis turns up too much sugar, protein, or red blood cells, your doctor may need more tests.
Red Blood Cell Count
These cells carry life-giving oxygen throughout your body. If you’re low on red blood cells, it might be a sign that you’re not eating enough nutrients, are bleeding internally, or have bone marrow problems. A high count might stem from heart disease or lung issues, among other causes. The general range for good health is 4.5 million to 5.9 million cells in a microliter of blood in men, and 4.1 million to 5.1 million cells in women.
White Blood Cell Count
These cells flood your body when they detect harmful invaders. So a high white blood cell count may be a sign that you’re fighting an infection, allergies, inflammation, or even cancer. A low count may mean bone marrow problems, a weakened immune system from conditions like HIV, or a poor diet. Stress and even too much exercise also can unleash your white blood cells. Normal levels for adults are 3.4 billion to 9.6 billion cells/L.
Thyroid-Stimulating Hormone
Your doctor might order this test if your thyroid gland is enlarged or has bumps. Other reasons include a fast pulse, unexplained weight loss, or other signs of an overactive thyroid. Low hormone levels may mean your thyroid is sluggish. Symptoms include weight gain, puffy and dry skin, and constipation. Medications, including multivitamins and supplements, can affect your test results. So tell your doctor about everything you take.
Platelet Count
These blood cells help heal wounds and stop bleeding. But too many platelets can form dangerous blood clots in your arms and legs that can cause heart attacks or strokes. Low platelet counts may make you bruise easily and to bleed from your gums, nose, and stomach. That may happen because of bone marrow illness, viral infection, or alcohol abuse, among other causes. A normal level is 150,000 to 450,000 platelets per microliter of blood.
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