BY KRISTEN FISCHER
IF YOUR cholesterol is high, perhaps
you’ve been told to go on a cholesterol-lowering statin.
In general, statins are drugs that
lower cholesterol in the blood by reducing the production of cholesterol in the
liver, lowering low-density lipoprotein
cholesterol (LDL, or bad cholesterol) and
reducing relative cardiovascular risk.
They can also raise levels of high-density
lipoprotein (HDL) cholesterol, which
helps carry harmful LDL and very-low-density lipoprotein (VLDL) out of the
body. Maintaining healthy cholesterol
levels helps prevent clogged arteries,
BY DAVID WIGHT
DEGENERATIVE DISK disease (DDD) is
a term used to describe normal changes to
spinal disks over time. Those disks serve
as shock absorbers between the vertebrae,
the bony segments that make up the spine.
With age, disks lose their integrity.
Magnetic resonance imaging (MRI)
studies show that most people over the age
of ;; have some degree of disk degeneration, according to the Arthritis Foundation.
But not everyone experiences DDD to the
degree that causes back or neck pain.
Spinal disks have a high water content
and tend to dehydrate as we age. Daily
activities, sports and injuries can cause
small tears in disks that enable the loss of
water content. There’s little blood supply
to the disks, so a compromised disk cannot repair itself as other body parts can.
Continued deterioration over time
results in a reduction in cushioning and a
narrowing of the spaces between vertebrae,
affecting how the segments of the spine
work together. Flexibility may be impaired,
and pain or inflammation may occur.
Symptoms most typically are isolated
to the back or the neck, depending on the
disk involved, and may include:
Degenerative disk disease
strokes and heart attacks.
Dr. Michael Miller, director of the
University of Maryland Medical Center’s
Center for Preventive Cardiology, agrees
that statins are typically the first line of
therapy for people with a risk of heart
attack or those with heart disease.
Countless studies show statins
decrease the risk of heart attack
and cardiovascular death.
The skinny on non-statins
The good news for people with high
cholesterol but a lower tolerance for statins is that statins are not the only way
to decrease cholesterol; there are other
medications to reduce cholesterol, as well
as non-medication therapies.
After reviewing ;; studies with data
from more than ;;;,;;; people, Dr. Marc
S. Sabatine—a cardiologist at Brigham
and Women’s Hospital in Boston—and
his team found that non-statins delivered
about the same heart health protection in
lowering cardiovascular risks as statins.
When should you choose a non-statin? Unless you already have had some
type of liver trouble, statins are typically
prescribed first. You and your health care
expert must monitor your reaction closely.
A non-statin would be recommended only
FOR YOUR HEALTH
after you find out that statins don’t work
for you, says Miller, a Costco member.
Non-statin options include:
Bile acid sequestrants. These prescription drugs bind with cholesterol-containing bile acids in the intestines and
Fibrates. Fibrates reduce the liver’s
production of a particle that carries triglycerides.
CETP inhibitors. These drugs reverse
the role of cholesteryl ester transfer protein (CETP), which normally transforms
HDL to VLDL or LDL cholesterol.
PCSK9 inhibitors. These prescription
drugs keep a cholesterol-clearing protein
in the liver longer to keep cholesterol from
Niacin. Also known as vitamin B;, niacin is better than statins at raising HDL,
athough not as effective at lowering LDL.
Bypass surgery. Heart bypass, or coronary artery bypass, surgery stops plaque
buildup in arteries due to cholesterol.
The first step is to have your cholesterol checked with a simple blood test. If
your cholesterol levels are high enough to
require medication, you and your doctor
can discuss your options. C
Kristen Fischer is a journalist in New Jersey.
• Pain ranging from nagging
• Back pain that extends to the
buttocks and legs.
• Neck pain that extends to the
arms and hands.
• Tingling or numbness in the
extremities (legs, arms).
• Headaches associated with neck pain.
• Reduction in range of motion;
pain may be worsened by reaching,
turning, twisting or bending.
Your doctor will conduct a physical
exam and review your medical history,
your symptoms and the exact circumstances under which you experience pain.
An MRI might show damage to disks.
Lifestyle changes such as smoking
cessation, following a healthy diet and
keeping your weight under control will
prove beneficial. Physical activity that
strengthens the muscles supporting the
spine is vital. Treatment will be based on
your symptoms and may include:
• Physical therapy.
• Over-the-counter pain (acetamino-
phen) and nonsteroidal anti-
inflammatory (ibuprofen or
naproxen sodium) medications.
• Heat/cold application.
• Surgery in some cases.
For more information:
• UCLA Spine Center,
• Arthritis Foundation,
• University of Maryland Medical
and cardiovascular death.