Q: I have high blood pressure and high cholesterol. The level was 7.9. My doctor put me on a blood pressure pill, 10 milligrams of Ramiprol once daily, and a cholesterol-lowering pill, Crestor. My blood pressure is now about 120-80 and my cholesterol is down to the three to four range. I feel fine, but I am concerned about the cholesterol-lowering drug ruining my liver. When I asked my doctor if I can stop taking it he replied “what do you want, a stroke or a heart attack?” Could you please give me your opinion? My mother has high blood pressure and is still alive at 92.
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A: I really take offence at doctors who give sarcastic answers like that. Here are some facts.
Cholesterol-lowering drugs are effective and the death rate from heart attacks has not been greatly changed by the use of these drugs.
There was an interesting study published in the British Medical Journal involving a large family from the Netherlands with a hereditary type of extremely high cholesterol levels. Their blood levels varied from 9.4 units to 13. They looked back at the causes of death going back to the 1800s and found that about half of them died from heart attacks or strokes.
In the old days there were no cholesterol-lowering drugs. But it is interesting that even with this drug, there was not much change in the mortality rates of this family. This suggests that there are other factors involved.
Also, heart attacks and strokes are still the most common causes of death in the western world.
It is true that the statin drugs such as Lipitor and Crestor do have some serious side effects that need to be taken into account when making a decision on whether to take them for the rest of your life.
As you say, they can be harmful to the liver, and in rare cases can cause a serious or fatal muscle problem known as rhabdomyolysis.
The drug companies pressure doctors into prescribing statin drugs because these are huge money makers. They also sponsor much of the research on cholesterol and heart attacks.
Having said that, statins have been shown to help prevent heart attacks and to lower the amount of disability that they cause. It is possible that they help not only by lowering cholesterol, but in other ways as well.
Maybe you need to talk to your doctor again about this, but ask him to hold the sarcasm and take your concerns seriously.
In my opinion, it is important that you do not stop taking your blood pressure pills because uncontrolled high blood pressure could cause you to have a stroke.
There are other ways you can lower your cholesterol.
For example, there is a powder called Questran that you can disguise in a drink or fruit juice. Even a simple thing like eating a bowl of oatmeal a day has been shown to be helpful.
Diet won’t help
Low cholesterol diets are not effective because your own body produces most of the cholesterol regardless of what you eat. You
really have to go almost completely vegetarian to receive much benefit from a diet.
On the other hand, having too low a cholesterol level may also lead to health problems. Some types of cancer have been linked to a low level and also depression. In Russia, doctors believe that low levels can cause heart attacks. Who is right?
With a mother still alive at 92, the genes seem to be in your favour. You didn’t say in your letter whether she is taking cholesterol-lowering pills.
Clare Rowson is a retired medical doctor living near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
