At the conference of the American Society of Clinical Oncology in June 2004, researchers revealed that people who took statins for at least five years appeared to cut their risk of colon cancer by 50%.

Earlier work with statins had shown reductions in breast and prostate cancer as well as general cancer risk. However, the evidence is still too weak to recommend that everyone take statins for cancer prevention alone. A carefully controlled experiment that would be designed specifically to show a reduced risk is needed. So far, the data pertain largely to patients who take statins for reasons other than cancer.

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People with type-2 diabetes mellitus (non-insulin-dependent diabetes) and coronary artery disease (CAD), as well as patients with diabetes and any other risk for cardiovascular disease, should be taking cholesterol-lowering drugs (statins), according to new guidelines published by the American College of Physicians (ACP).

Approximately 80% of people with type-2 diabetes experience or die of complications of heart and vascular disease, and about 65% of deaths among people with diabetes are a result of heart disease and stroke, according to the American Diabetes Association. Diabetes is itself a major risk factor for heart disease.

The ACP recommends that:

• All adults with type-2 diabetes and known CAD take statins, regardless of cholesterol levels.
• All type-2 diabetic patients with another risk factor for CAD take statins or the non-statin drug gemfibrozil (Lopid tablet, Parke-Davis) regardless of cholesterol levels.
• Routine monitoring of liver function or muscle enzymes is probably not needed for patients with type-2 diabetes who are taking statins unless they also have a liver abnormality or muscle pain or are taking drugs that interact with statins.

Statins exert multiple benefits, such as anti-inflammatory, immunomodula-tory, and antithrombotic effects. An analysis of data from 69,168 patients with atherosclerosis in Ontario, Canada, suggests that statins might help reduce the risk of sepsis as well.

During a mean follow-up of two years, 551 patients who were given statins and 667 patients in the non-statin group were admitted for sepsis. Statins were associated with a 19% lower risk of sepsis. The apparent protective association was consistent for several high-risk subgroups throughout the entire follow-up.
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Earlier research had suggested that statins substantially reduce inflammatory cytokines and the overproduction of nitric oxide, which is implicated in the vasodilation and circulatory collapse of septic shock, the researchers say. In addition to their effects on the host,  statins also seem to lessen the replication and infectivity of several bacterial, fungal, and viral pathogens.

Health care providers might be wondering whether their patients will use statin therapy as an excuse to change their diet—for the worse. No need to worry, say researchers from Mount Sinai, Columbia University, Veterans Affairs Medical Center and New York University, and Weill Medical College, all in New York; and the Mayo Clinic in Rochester, Minnesota.

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More elderly patients at risk for con gestive heart failure are getting aggressive statin therapy when they need it. Researchers from Kaiser Permanente Center for Health Research in Portland, Oregon, say that the 2004 update to the National Cholesterol Education Program Adult Treatment Panel III guidelines and the corresponding revision of internal guidelines in the large health maintenance organization they studied resulted in more patients receiving minimal-guideline statin therapy.

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Health care providers might be wondering whether their patients will use statin therapy as an excuse to change their diet—for the worse. No need to worry, say researchers from Mount Sinai, Columbia University, Veterans Affairs Medical Center and New York University, and Weill Medical College, all in New York; and the Mayo Clinic in Rochester, Minnesota.

Read the rest of this entry »

More elderly patients at risk for congestive heart failure are getting aggressive statin therapy when they need it. Researchers from Kaiser Permanente Center for Health Research in Portland, Oregon, say that the 2004 update to the National Cholesterol Education Program Adult Treatment Panel III guidelines and the corresponding revision of internal guidelines in the large health maintenance organization they studied resulted in more patients receiving minimal-guideline statin therapy.

Read the rest of this entry »