Which is effective in lowering cholesterol, statins, or dietary supplements?

Dr V Mohan, a diabetes specialist, said the results were not surprising given that statins are more effective than exercise and lifestyle changes when it comes to lowering LDL levels.

Why are statins the mainstay of treatment for cholesterol control?

When talking about lipids, there are different categories such as cholesterol and triglycerides.Cholesterol includes LDL (bad) cholesterol and HDL (good) cholesterol. Several studies, including our own, now show that LDL is more important than triglycerides when it comes to managing heart disease. The same is true for

That said, there are some Scandinavian studies showing that even triglycerides are an important factor in heart health. LDL becomes smaller, denser, and more atherogenic (more likely to deposit in arteries). That’s when the secondary role of triglycerides becomes important.

But when you put them in competition with each other, lowering LDL levels becomes much more important. Reducing intake lowers triglycerides, but not so easily lowering LDL.

It is now well established that statins reduce heart attacks, reduce all-cause mortality, cardiac mortality, and lower levels of all-cause mortality. is far outweighing the risks. The only time you should think about triglycerides is after you control your LDL levels.

Who should be given statins?

Statins are not for everyone. It should only be prescribed to people with high LDL levels. People with LDL levels of 130 and diabetes should definitely take it. Non-diabetics should take if the number is above 160. People who do not have diabetes but have a family history of heart disease, have had a heart attack, or have had a stent placed should use a course of statins. High dose statins – for example 80 mg instead of 10 or 20 mg – are used by cardiologists after a heart attack. This is because it is thought to reduce plaque in the coronary arteries and help stabilize them (plaque is a lipid deposit in the arteries that eventually blocks blood flow and causes a heart attack). .

In fact, heart disease and diabetes are much more prevalent in India’s younger population than in the West.

Why are statins more important than lifestyle changes when it comes to LDL?

Improving lifestyle habits is also important. They can lead to weight loss, which can result in lowering various lipids, including triglycerides. However, diet and exercise all have lesser effects on LDL than statins.

This is because LDL cholesterol is made in the liver. Diet therefore plays a small role. If your LDL level is 140, lifestyle changes will bring it down to 125, but statin therapy will stop LDL production and drop it to 80.

Elevated LDL levels are also genetic. I have family members who have heart attacks very early on. I knew a family member who had a heart attack at age 26 or her age 30. For a long time, many families were not over the age of 35. They live longer after using high-dose statins.

Why are some people still hesitant to take statins?

These are harmless drugs. In fact, most people I meet at my clinic won’t refuse it, except for those who read too much on WhatsApp University.

A very small number of people, perhaps 1 in 5,000, are statin intolerant. They develop severe muscle pain and cannot even walk. Therefore, people without such contraindications can safely prescribe it.

Once you take a statin, it usually lasts for the rest of your life. A rebound occurs the moment you stop, and it can be higher than before. But these are harmless drugs, have few side effects, are cheap, one tablet at night.

Do supplements like fish oil have any effect on the heart?

Fish oil or omega-3 fatty acids are always present, but act on triglycerides instead of reducing LDL. There is no harm in ingesting it, but people who have fish will ingest it anyway. Vegetarians don’t like it because it comes from fish oil anyway.

Omega-3s, like aspirin, also slightly increase the risk of bleeding. Therefore, it cannot be given to anyone. Statins are much more widely available.

Why Dr. V Mohan? Dr. Mohan is a recognized diabetes specialist and chairman of Dr. Mohan’s Center for Diabetes Specialty. He is also president of the Madras Diabetes Research Foundation, an ICMR advanced center for studying the genomics of type 2 diabetes, and has over 1,500 publications. He has also received the Dr BC Roy Award, India’s highest honor for physicians, and Padma Shri, the fourth highest civilian award.