Reducing Heart Risks

Reducing Heart Risks

If a patient cannot control heart risk factors with lifestyle measures, treatment may be needed.

Drug Treatment for Unhealthy Cholesterol and Lipid Levels

Aggressive control of cholesterol levels is known to reduce death rates in patients with peripheral artery disease (PAD). Unhealthy cholesterol levels are major contributors to atherosclerosis, the common factor in PAD and heart disease. Many experts now recommend that patients with PAD receive drugs to lower cholesterol.

There are a number of drugs available for lowering cholesterol. Those discussed in this report are believe to have particular benefits for patients with PAD. [For more information on these cholesterol-lowering drugs, see In-Depth Report #23: Cholesterol.]

Statins. Statins are the most effective drugs for the treatment of high cholesterol. Statins block the liver enzyme hMG-CoA reductase, which the body uses to make cholesterol. Statins are particularly effective for lowering LDL levels and triglycerides. They also raise HDL levels, but not as much as other anti-cholesterol drugs.

Statins include:

• Lovastatin (Mevacor)
• Pravastatin (Pravachol)
• Simvastatin (Zocor)
• Fluvastatin (Lescol)
• Atorvastatin (Lipitor)
• Rosuvastatin (Crestor)

Statins reduce the risk of heart attack and stroke. Evidence now strongly suggests that statins have specific benefits for patients with PAD. In a 2003 study, statin use was associated with improved leg function, regardless of the patients' cholesterol levels.

• Statins improve the function of the lining of blood vessels, which improves blood flow.
• Statins appear to reduce inflammation in the arteries, which is now believed to be a major factor in blood vessel injury.
• Some evidence suggests that statins might promote growth of new blood vessels and help prevent intermittent claudication.

Side effects of statins include headaches, skin rashes, muscle aches, sexual dysfunction, drowsiness, dizziness, nausea, constipation, and peripheral neuropathy (numbness or tingling in the hands and feet).