CHOLESTEROL WATCH

Cutting Carbs Could Lower Cholesterol

Lowering carbohydrate intake can result in healthier blood fat levels, even if a patient does not lose weight. Scientists have found that carbohydrates, especially the simple sugars, can cause fat to collect in the liver, just as it does on the thighs and in the abdominal area. The liver fats eventually end up in the bloodstream. Cutting down on carbohydrate intake can help lower these fatty deposits and also may boost the body's ability to break down those fats that do make it into the bloodstream. The findings were published in the May 2006 edition of the American Journal of Clinical Nutrition.

Researchers investigated the effects of moderate reductions in carb intake on cholesterol levels by studying 178 overweight men who ate a standard diet, including 54% of energy intake from carbs, for 1 week. These men then were randomly assigned to either continue the same diet or to switch to either a 39% or a 26% carbohydrate diet, for 3 weeks. For 5 more weeks, the men ate similar diets but with lower caloric intake to help promote weight loss. For the last 4 weeks, their energy intake was adjusted to stabilize their weights.

The men with the lowest carb intake showed reductions in their harmful triglycerides and low-density lipoprotein levels. They also had an increase in their high-density lipoprotein levels, compared with the men who maintained their regular diets.

Popular Supplement May Not Lower Cholesterol

Contrary to previous research, a new study has found that the nutritional supplement policosanol was no more effective at lowering cholesterol levels than placebo. The study authors said in a statement that "policosanol had no effects on blood lipids beyond placebo, not even with very high doses."

Although there have been many studies documenting the positive cholesterol-lowering attributes of the supplement, the authors noted that most of that research came from one single research group in Cuba. They believed that there was a need to confirm those findings in an independent study.

The researchers recruited 143 people and randomly assigned them to 5 different treatment groups. Twenty percent received a placebo, and the rest were divided into 4 groups to receive either 10, 20, 40, or 80 mg of policosanol daily for 12 weeks.

At the end of the study, the researchers found that, although there were no ill effects, there was no statistically significant difference in the cholesterol levels among all the groups. The results of the study appeared in the May 17, 2006, issue of the Journal of the American Medical Association.

Cholesterol Medicines Might Improve Heart Rhythm

A recent study showed that patients with enlarged hearts who use statins had considerable reductions in mortality, which was largely due to an antiarrhythmic effect. The researchers with the multicenter Defibrillators in Nonischemic Cardiomyopathy Treatment Evaluation trial studied the survival benefits and effects of statin therapy on sudden cardiac death in 458 patients with cardiomyopathy. Of these patients, 229 were randomly selected to receive an implantable cardioverter defibrillator to correct abnormal heart rhythms. The devices are programmed to detect the abnormalities and to deliver a shock to restore normal rhythm.

Patients on statin therapy were shown to have a 78% reduction in mortality rates. After monitoring the subjects for almost 2000 days, the researchers found that the patients who had the defibrillator and were on statin therapy were 39% less likely to die from arrhythmic effects than the others. Also, of the patients with defibrillators, those on statins were less likely to require the necessary shock to restore normal heart rhythm than those not taking the drugs. The findings were presented at the Heart Rhythm Society's 27th Annual Scientific Sessions in Boston, Mass.

Older Patients Skip Cholesterol and Blood Pressure Drugs

A recent review of the medical records of a group of elderly patients showed that only 32.9% of them took the drugs they were prescribed to treat either high cholesterol or hypertension. Investigators at ValuMedics Research in Falls Church, Va, did an analysis of data from 4052 patients aged 65 or older who were enrolled in the Protocare Sciences Managed Care Database. High cholesterol and hypertension medications were initially prescribed for a 90-day period. Researchers defined adherence as patients filling prescriptions to cover at least 80% of the days of drug therapy.

The study results showed that adherence dropped for both drug classes to 40.5% by the 3-month mark and to 32.7% at 6 months, then leveled off at 32.9% at 12 months.Adherence to cholesterol medications fell lower than that for hypertension drugs. Patients may believe that high blood pressure is more of a problem. The findings were presented at the American Heart Association's 7th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Diseases and Stroke.