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Mitigate Heart Health Risks With Statin Drugs

Dear Dr. Roach: A recent column mentioned statin drugs and their effect on women. In August 2008, my internist said studies had shown that statin drugs for diabetics promoted heart health. At the time, my A1c was 5.8, total cholesterol 139 and LDL 75. He prescribed 5 mg Crestor every other day.

By June 2009, my total cholesterol was 104 and LDL 43. My internist still wanted me to continue with Crestor, but lowered it to twice a weekly because I was concerned that my LDL was too low. I have a new internist now, and my last report shows total cholesterol 110, HDL and LDL 56. My A1c is 5.7. She suggests I consider stopping Crestor. The internist who prescribed Crestor specialized in diabetes, and the doctor I see now does not. I’m 65 and was diagnosed with Type 2 diabetes 10 years ago. — S.M.

Answer: Statin drugs have been proven to reduce the risk of heart attack and death in many different populations. As a general rule, the higher the risk of heart disease to begin with, the more benefit from statins. Men have higher risk than women, and diabetics have a higher risk than non-diabetics. The higher the total or LDL cholesterol, the higher the risk, but also low HDL cholesterol levels increase risk of heart disease. Of course, the older you are, the higher the risk. Your doctor needs to keep all of these risks in mind, as well as your family history, diet and exercise habits, smoking history and blood pressure, in order to determine whether to recommend a statin to you.

Some authorities recommend treating people with diabetes with a statin regardless of LDL level. I used an online calculator to estimate your risk of a heart attack in the next five years based on your cholesterol without treatment, and it is about 5 percent. With treatment, your risk drops to about 4 percent. So the medication does reduce your risk a bit: 100 people like you would need to be treated for five years to prevent one heart attack.

As far as the dangers of too-low LDL go, there was some concern about it in the 1980s, but more recent data suggests that even very low LDL from statins doesn’t cause problems.

Dear Dr. Roach: I am in the market to purchase an infrared sauna for health purposes. My research indicates that infrared is good for many health reasons, such as arthritis, Type 2 diabetes, detox, cholesterol, weight loss, relieving muscle pain, helping kill cancer cells, etc.

I have arthritis, and my boyfriend has diabetes. My question is this: Is this all true, and can it help me to become a healthier person? I would use the sauna daily or three to four times a week.

Do you feel it is worth the purchase as a preventive tool for staying healthy? — D.O.

Answer: An infrared sauna uses light waves to heat up the body. People have been using traditional saunas for centuries, and many swear by their benefits. There is good evidence that saunas (and infrared saunas in particular) can reduce pain and stiffness from some kinds of arthritis. Unfortunately, there isn’t evidence to support it, and I doubt that saunas do help with “detox,” weight loss or killing cancer cells. I would caution your boyfriend with diabetes, because some people with diabetes are less sensitive to heat and could be burned without knowing it.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.