Do Heart Patients Get Too Many Cholesterol Tests?

Unnecessary screenings contribute to rising U.S. health costs, study suggests

By Steven Reinberg

HealthDay Reporter

MONDAY, July 1 (HealthDay News) -- Many U.S. heart patients may be getting their cholesterol levels checked unnecessarily, a new study suggests.

Statistics on more than 35,000 patients with coronary heart disease treated in a Houston-based Veterans Affairs network suggest this is an area of over-testing that's contributing to the nation's soaring medical costs, the study authors said.

At this one network of seven hospitals, the cost of redundant cholesterol blood tests amounted to more than $200,000 in one year, the study found.

"These results represent health care resource overuse and possibly their waste," said lead researcher Dr. Salim Virani, a cardiologist at the Michael E. DeBakey Veterans Affairs Medical Center in Houston.

The study, published online July 1 in JAMA Internal Medicine, zeroed in on almost 28,000 patients taking statin drugs that were keeping their cholesterol levels in check -- less than 100 milligrams of cholesterol per deciliter of blood.

Over 11 months, repeat tests were ordered for one-third of those patients even though their medication had not been increased, the researchers found.

In all, nearly 13,000 additional tests were performed at about $16 each, bringing the total cost for this one group of hospitals to almost $204,000.

"Apart from the costs associated with these lipid panels, this also carries with it the cost for the patient's time to undergo a repeat blood test and cost for the health care provider's time to follow up on these results after redundant testing and to inform the patient about these results," said Virani.

Most of those who underwent repeat testing had a history of diabetes, high blood pressure and more frequent doctor visits, the research team found. The extra tests likely gave some of these patients a measure of comfort, the study authors noted.

The study drew mixed reactions from other experts.

Current national guidelines recommend that patients with coronary heart disease have their cholesterol checked every four to six months, said Dr. Gregg Fonarow, professor of cardiology at the University of California, Los Angeles and a spokesman for the American Heart Association.

"This new study shows a pattern of lipid testing that is entirely consistent with current guidelines," he said. "Whether less frequent testing and monitoring would result in similar outcomes at lower cost requires more study."

Using statin therapy to achieve and maintain appropriate LDL cholesterol levels remains one of the most cost-effective therapies for preventing recurrent cardiovascular events in men and women with coronary heart disease, he said.

Dr. Joseph Drozda Jr., author of an accompanying journal editorial, said that "seemingly inexpensive tests" really add up when done in large numbers.

"These cholesterol tests were being ordered with no benefit to the patient but cost the VA more than $200,000, and this was only in seven hospitals," said Drozda, from the Center for Innovative Care at Mercy Health in Chesterfield, Mo.

Drozda thinks this is just one example of the overuse of tests. "Most physicians will tell you this is not uncommon. A lot of tests are ordered without direct benefit to the patient and result in this kind of waste," he said.

"We need to be looking for all of these sources of waste and addressing them," he added.

About one of every six adult Americans has high blood cholesterol, putting them at risk of heart disease, according to the U.S. Centers for Disease Control and Prevention.

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Cholesterol Drugs Might Boost Kidney Cancer Survival

Study finds statin medications tied to lower death risk after nearly 4 years of follow-up

By Robert Preidt

HealthDay Reporter

TUESDAY, May 7 (HealthDay News) -- Cholesterol-lowering statin drugs that are taken by millions of Americans might also improve survival from a type of kidney cancer called renal cell carcinoma, a new study suggests.

Statins -- drugs such as Crestor, Lipitor, Pravachol and Zocor -- have anti-inflammatory and cell self-destruction properties, and previous research has shown that these drugs may lower the risk of developing some types of cancer. The new research, presented Tuesday at the annual meeting of the American Urological Association in San Diego, suggests that the drugs might fight kidney cancer.

"Given that one in four Americans over 45 years of age take a statin and renal cell carcinoma occurs most often in men ages 50 to 70, it may be prudent to prospectively evaluate if statins protect against [cancer] progression," study author Dr. Scott Eggener, an associate professor of urologic oncology at the University of Chicago, said in a meeting press release.

One expert not connected to the study wasn't surprised by the findings.

"The use of statins has shown promise in previous studies with reducing overall cancer-related mortality," said Dr. Michael Palese, an associate professor of urology at the Icahn School of Medicine at Mount Sinai, in New York City. He added that certain characteristics of renal cell carcinomas might render statins "beneficial" for patients.

In the study, Eggener's team reviewed data from more than 900 patients who had surgery for renal cell carcinoma between 1995 and 2010. After an average follow-up period approaching four years, statin use was associated with a reduced risk of cancer progression, the team reported.

Over three years, 10 percent of the patients who took statins died of their cancer, compared with 17 percent of those who did not take this type of drug.

After accounting for other factors, the researchers concluded that statin use was independently associated with both improved overall survival and disease-specific survival.

Another expert said the finding echoes those seen in other studies involving cancer patients.

"Last year in a study published in the New England Journal of Medicine, Danish researchers studied 13 different cancers and found that in all types, the use of statins was associated with longer cancer specific survival," said Dr. Manish Vira, director of the fellowship program in urologic oncology at North Shore-LIJ's Arthur Smith Institute for Urology in Lake Success, N.Y.

But he stressed that the data so far come from observational trials, which can prove an association but not a cause-and-effect relationship between statin use and improved survival.

"Given the current data and known cardiovascular protective effects of statins, certainly it seems prudent to design clinical trials to study the potential of statin therapy in breast, colon, prostate and now kidney cancer treatment," Vira said.

Studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

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Cholesterol Drugs Might Boost Kidney Cancer Survival

TUESDAY, May 7 (HealthDay News) -- Cholesterol-lowering statin drugs that are taken by millions of Americans might also improve survival from a type of kidney cancer called renal cell carcinoma, a new study suggests.

Statins -- drugs such as Crestor, Lipitor, Pravachol and Zocor -- have anti-inflammatory and cell self-destruction properties, and previous research has shown that these drugs may lower the risk of developing some types of cancer. The new research, presented Tuesday at the annual meeting of the American Urological Association in San Diego, suggests that the drugs might fight kidney cancer.

"Given that one in four Americans over 45 years of age take a statin and renal cell carcinoma occurs most often in men ages 50 to 70, it may be prudent to prospectively evaluate if statins protect against [cancer] progression," study author Dr. Scott Eggener, an associate professor of urologic oncology at the University of Chicago, said in a meeting press release.

One expert not connected to the study wasn't surprised by the findings.

"The use of statins has shown promise in previous studies with reducing overall cancer-related mortality," said Dr. Michael Palese, an associate professor of urology at the Icahn School of Medicine at Mount Sinai, in New York City. He added that certain characteristics of renal cell carcinomas might render statins "beneficial" for patients.

In the study, Eggener's team reviewed data from more than 900 patients who had surgery for renal cell carcinoma between 1995 and 2010. After an average follow-up period approaching four years, statin use was associated with a reduced risk of cancer progression, the team reported.

Over three years, 10 percent of the patients who took statins died of their cancer, compared with 17 percent of those who did not take this type of drug.

After accounting for other factors, the researchers concluded that statin use was independently associated with both improved overall survival and disease-specific survival.

Another expert said the finding echoes those seen in other studies involving cancer patients.

"Last year in a study published in the New England Journal of Medicine, Danish researchers studied 13 different cancers and found that in all types, the use of statins was associated with longer cancer specific survival," said Dr. Manish Vira, director of the fellowship program in urologic oncology at North Shore-LIJ's Arthur Smith Institute for Urology in Lake Success, N.Y.

But he stressed that the data so far come from observational trials, which can prove an association but not a cause-and-effect relationship between statin use and improved survival.

"Given the current data and known cardiovascular protective effects of statins, certainly it seems prudent to design clinical trials to study the potential of statin therapy in breast, colon, prostate and now kidney cancer treatment," Vira said.

Studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCES: Michael Palese, M.D., associate professor, urology, Icahn School of Medicine at Mount Sinai, New York City; Manish A. Vira, M.D, director, fellowship program in urologic oncology, North Shore-LIJ Arthur Smith Institute for Urology, Lake Success, N.Y.; American Urological Association, news release, May 7, 2013

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Secondhand Smoke Tied to Lower 'Good' Cholesterol in Teen Girls

Living with smokers may raise risk for heart disease, study suggests

By Robert Preidt

HealthDay Reporter

TUESDAY, April 30 (HealthDay News) -- Exposure to secondhand smoke at home appears to lower teen girls' levels of the "good" cholesterol -- the substance that reduces heart disease risk, researchers report.

The new study included more than 1,000 male and female teens, aged 17, in Australia who had blood tests to check their levels of "good" high-density lipoprotein (HDL) cholesterol. While "bad" low-density lipoprotein (LDL) cholesterol creates a build-up that can block blood vessels, HDL plays a positive role by clearing excess cholesterol from the bloodstream.

The researchers also examined information about smoking in the teens' households beginning before they were born, when their mothers were 18 weeks into their pregnancies. Forty-eight percent of the study participants had been exposed to secondhand smoke at home, according to the study in the May issue of the Journal of Clinical Endocrinology & Metabolism.

"In our study, we found 17-year-old girls raised in households where passive smoking occurred were more likely to experience declines in HDL cholesterol levels," lead author Dr. Chi Le-Ha, of the University of Western Australia, said in a news release from the Endocrine Society.

"Secondhand smoke did not have the same impact on teenage boys of the same age, which suggests passive smoking exposure may be more harmful to girls. Considering cardiovascular disease is the leading cause of death in women in the western world, this is a serious concern," Le-Ha added.

The findings suggest that exposure to secondhand smoke in childhood may be a more significant risk factor for women than men.

"We need to redouble public health efforts to reduce young children's secondhand smoke exposure in the home, particularly girls' exposure," Le-Ha stated in the news release.

The association seen in the study does not prove that there is a cause-and-effect relationship between secondhand smoke exposure in girls and low levels of HDL cholesterol.

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Cholesterol Drugs Linked to Muscle, Joint Problems: Study

But heart benefits of statins outweigh risks, expert says

By Steven Reinberg

HealthDay Reporter

MONDAY, June 3 (HealthDay News) -- People taking statin drugs to lower their cholesterol may slightly increase their risk for muscle and joint diseases as well as strains and sprains, a new study suggests.

Statins, such as Zocor and Lipitor, are widely used to reduce cholesterol levels and help prevent heart disease. But they're also thought to contribute to muscle weakness, muscle cramps and tendon problems.

This new study, based on nearly 14,000 U.S. active-duty soldiers and veterans, confirmed an association between the drugs' use and musculoskeletal injuries and diseases. But the findings need to be replicated in other types of studies and should not deter people at risk of heart disease from taking the medications, said lead researcher Dr. Ishak Mansi, from the VA North Texas Health Care System in Dallas.

"Do not stop taking statins; these medications have been life-savers for some patients," Mansi said. "But talk to your doctor about the benefit-risk ratio for you."

Whether statins should be prescribed universally in people without risk factors for heart disease, as some in the health care field suggest, is another matter, Mansi said.

"The side effects of statins are not totally known yet," Mansi said. "Advocating widespread use, specifically for primary prevention in otherwise healthy subjects, is unsound."

The researchers matched nearly 7,000 statin users with a similar number of nonusers to assess the risk of musculoskeletal problems associated with statin use. The results were published online June 3 in the journal JAMA Internal Medicine.

They found that people taking statins had a 19 percent greater risk of having musculoskeletal problems compared with nonusers. Specifically, statin users were 13 percent more likely to suffer dislocations, strains or sprains. They were only 0.7 percent more likely to develop osteoarthritis or other joint problems, which was not considered statistically significant, the researchers found.

The greater likelihood of strains, sprains and dislocations with statin use has not been previously reported, the researchers said. The findings might have implications for physically active people, such as members of the military.

Dr. Gregg Fonarow, spokesman for the American Heart Association, said statin users should be reassured by the findings.

"This study provides further evidence that the proven cardiovascular benefits outweigh any potential risks, including musculoskeletal issues," said Fonarow, a professor of cardiology at the University of California, Los Angeles.

"Statins have been demonstrated in multiple large-scale, prospective, randomized, placebo-controlled trials to reduce the risk of ... cardiovascular events in men and women with or at risk for cardiovascular disease," he said. "In these gold-standard clinical trials there has been no increased risk of musculoskeletal disease."

In the current study, three-quarters of the participants were taking simvastatin (brand name Zocor) and about 20 percent were taking atorvastatin (Lipitor). Smaller numbers were prescribed pravastatin (Pravachol), rosuvastatin (Crestor), fluvastatin (Lescol) or lovastatin (Mevacor).

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Cholesterol Levels May Vary By Season

Title: Cholesterol Levels May Vary By Season
Category: Health News
Created: 3/7/2013 12:36:00 PM
Last Editorial Review: 3/8/2013 12:00:00 AM

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Cholesterol Levels May Vary By Season

Brazilian study doesn't necessarily mean that heart attack or stroke risk rises in winter

By Steven Reinberg

HealthDay Reporter

THURSDAY, March 7 (HealthDay News) -- Cholesterol levels increase with winter's arrival and drop again as warmer weather returns, a new study by Brazilian researchers suggests.

"In the winter, people should be careful with their cholesterol levels," said lead researcher Dr. Filipe Moura, a doctoral student at the State University of Campinas.

Whether these changes in cholesterol are putting patients at risk for heart attacks or stroke isn't clear, Moura said. It's a complex picture and these changes might have a role, but there are many other factors, he added.

There are several possible reasons cholesterol varies by season, Moura said, including changes in diet, exercise and exposure to the sun.

"In the winter, people consume more calories and eat fattier foods, which could have an effect on their bad cholesterol," he said. "Also, it's common for people to exercise less during the winter and stay in more."

People also get less sun in the winter, so they get less vitamin D, which can have an effect on cholesterol, Moura said. He also noted that during the winter people are prone to colds and the flu, which can effect cholesterol levels.

The study findings were scheduled to be presented Saturday at the annual meeting of the American College of Cardiology in San Francisco.

Moura's team collected data on more than 227,000 people who had their cholesterol checked in primary-care centers in the Brazilian city of Campinas between 2008 and 2010.

The researchers found that during the winter, low-density lipoprotein (LDL), or "bad" cholesterol, rose an average of 7 milligrams per deciliter compared to the summer, which is about an 8 percent increase during the cold months. During the summer, levels of high-density lipoprotein (HDL), the "good" cholesterol, rose about 9 percent, but so did levels of fats in the blood called triglycerides, which rose about 5 percent, the researchers found.

This is different than what other studies have found, Moura said. A possible explanation is Campinas's climate. The city's elevation is roughly 1,800 to 2,500 feet above sea level, and the winters are mild and dry.

Moura said these changes may be even more extreme in the United States, Europe or other areas that have bigger climate changes between winter and summer.

He next plans to look at patients with heart disease to see whether the seasonal change in cholesterol results in more heart attacks.

What these findings mean for patients isn't clear, said Dr. Gregg Fonarow, a spokesman for the American Heart Association and a professor of cardiology at the University of California, Los Angeles.

"This study suggests there may be modest seasonal variation ... with higher LDL levels in winter months compared to summer, but further studies are needed to confirm these findings and whether there is any meaningful impact on cardiovascular risk," Fonarow said.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

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For Diabetes: BP, Cholesterol Key v. Heart Disease

Jan. 28, 2013 -- People with diabetes who want to lower their risk of heart attack and stroke should focus on controlling their blood pressure and ''bad'' cholesterol, according to a new study of more than 26,000 patients.

Controlling both these risk factors, the researchers found, made patients less likely to be hospitalized for heart attacks or strokes than those who only controlled blood sugar during the six-year follow-up.

"It's not that blood glucose is not important. It's that low-density cholesterol and blood pressure control are more important if cardiovascular disease is what you are trying to prevent," says Gregory A. Nichols, PhD, a senior investigator at Kaiser Permanente Center for Health Research.

The study is published in the Journal of General Internal Medicine.

More than 18 million people in the U.S. have diabetes, according to the American Diabetes Association. 

Those with type 2 diabetes (in which the body doesn't make enough insulin or use it properly) have a higher risk of heart disease and stroke.

To minimize the risk, research suggests, those with diabetes should control not only blood sugar levels but also their LDL or ''bad" cholesterol and their blood pressure.

However, Nichols says, he is not aware of any study that looked at the contribution of these risk factors to heart attack or stroke risk among people with diabetes.

For the new study, the researchers calculated all patients' average values on systolic blood pressure (the upper number of the reading), cholesterol, and blood sugar levels.

"There were actually eight different possible categories," Nichols says. These ranged from having none of the risk factors under control to having all of them under control.

Guidelines suggest that systolic blood pressure in those with type 2 diabetes should be less than 130.

"LDL ideally is less than 100 [mg/dL] and A1c [a blood sugar measure] is less than 7%," Nichols says.

Next, they looked at whether the patients had a hospital admission with a diagnosis of heart disease or stroke. During the study, 1,943 patients were hospitalized for those reasons.

Those who were in the hospital were on average 65 years old. Those who were not were on average 58.

Nichols looked at the risk factor status of all patients.

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Foods To Keep Your Cholesterol In Control

Guest Post by Kelly Jones….

Are you suffering from cholesterol and before eating anything you first thing of its effect on your cholesterol rate? How about eating a salmon fish for dinner tonight, or grabbing a handful of nuts or even better to lick that dark chocolate. Yes, a person having cholesterol can enjoy all this guilt-free! All these foods and many more help in keeping your cholesterol level in control. All you need to do is whatever you eat just eat healthy food.

So here is a list of 9 Foods which help you in fighting with cholesterol:

Fats are always not bad; our body needs some healthy fats for proper functioning. Fats like Mono-unsaturated fats, poly-saturated fats and saturated fats are good for your health. So Nuts provide you good amount of all these healthy fats to your body.

If you don’t like that doctors prescribed boiled food on your breakfast than try having Oats, which also helps a lot in keeping your cholesterol in control. Take two servings of oats in a day to lower LCL cholesterol by 5.3% in 6 weeks.

Yes raise a toast to your health with the best of the red wine. The red grapes used in the manufacturing of the red wine helps to lower the cholesterol level. Just two glasses of red wine in a week can do the magic.

Green vegetables are like a lifeline of healthy life. So just add beans to your diet add get those cholesterol levels down by 8%.

Chocolates have those cholesterol reducing antioxidants in them. Studies done have proved that dark chocolates prevent blood vessels in lever from rupturing.

Not only Popeye you can also build that muscle power with spinach. It is proven that spinach contains around 13 falconoid elements which keep you away from harmful diseases like cancer, heart diseases and many more.

If you are non vegetarian than, salmon is like a health wonder for you. It keeps your heart safe from conditions like heart attack, stroke, and keep cholesterol levels at bay. Fishes like salmon, sardines help in increasing good cholesterol levels.

One should prefer tea than coffee, as tea has antioxidants in it and less amount of caffeine content is present in it. Your bones become strong due to presence of phytochemicals in tea. It also helps in increasing your defense mechanism of the body against LDL cholesterol levels.

This is the most common which everyone knew that cholesterol patients should use olive oil instead of normal cooking oil in eating. It has many health benefits, also helps in lowering bad cholesterol level in body.

So add these foods in your daily diet and enjoy a healthy life and those cholesterol levels low.

Kelly Jones writes for Tustin Auto Center. She is a freelance blogger and likes to write about various topics like social media, latest technology trends.

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