THE NEW ENGLAND JOURNAL ON THE ENHANCE STUDY CHOLESTEROL LOWERING WITH VYTORIN AND A VIDEO OF CLEVELAND CLINIC CARDIOLOGIST ON ZETIA AND VYTORIN

According to the NY Times, "Two widely prescribed cholesterol-lowering drugs, Vytorin and Zetia (ezetimibe), may not work and should be used only as a last resort, The New England Journal of Medicine said in an editorial published on Sunday" about the cholesterol lowering drugs. Vytorin is two cholesterol lowering drugs , one a statin, Zocor, which is the strongest class of cholesterol lowering medicines and one a drug called Zetia.




Actually what they said in the editorial was "As noted by Brown and Taylor, the data from this trial, which are based on measurements of intima–media thickness (This refers to the inner wall thickness of the blood vessel) in lieu of clinical end points, do not directly address the question of whether the lowering of LDL cholesterol with ezetimibe is clinically beneficial". "Until such data are available, it seems prudent to encourage patients whose LDL cholesterol levels remain elevated despite treatment with an optimal dose of a statin to redouble their efforts at dietary control and regular exercise. Niacin, fibrates, and resins should be considered when diet, exercise, and a statin have failed to achieve the target, with ezetimibe reserved for patients who cannot tolerate these agents".

Cholesterol Lowering and Ezetimibe




"The journal’s conclusion came as doctors at a major cardiology conference..saw for the first time the full results of a two-year clinical trial of the cholesterol lowering drugs, that showed that the drugs failed to slow, and might have even sped up, the growth of fatty plaques in the arteries. Growth of those plaques is closely correlated with heart attacks and strokes".






Doctors knew that Zetia did not lower cholesterol as much as the statins but it was hoped that in some people the effect would be enough to do the trick. However, reports have questioned if Zetia, even if lowering cholesterol,is helping sufficiently and if it has any impact on the buildup of plaque deposits in the arteries of the heart. When too much plaque lines the walls of the arteries it increases the chance that an artery can become clogged and close off thus setting in motion a heart attack.

Click here to READ ABOUT STATINS THE MOST POWERFUL CHOLESTEROL REDUCERS AND HOW THEY WORK AND SIDE EFFECTS



Watch a video of a famous cardiologist at Cleveland Clinic talk about his ideas about Zetia and the Vytorin study.The study questions the value of Zetia to halt or decrease artery clogging atherosclerotic plaque in the heart . Zetia has been viewed as a way to lower cholesterol without the possible systemic side effects of the more powerful statin cholesterol drugs. Some people just don't like or tolerate statins like Lipitor, Crestor or Zocor.


Cleveland Clinic Doctor Talks About Zetia Problems Click the Arrow to Start










"You've just seen a negative trial that should change practice," said Dr. Harlan Krumholz. "It seems to be a very strong study."



"Krumholz spoke on behalf of a panel of four doctors that included Rick Nishimura of the Mayo Clinic, Patrick O'Gara of Brigham and Women's Hospital and Joseph Messer, with a private cardiology practice in Chicago. Financial disclosures show Krumholz has testified against Merck in Vioxx-related litigation while the other three doctors reported no financial interests or relationships with pharmaceutical firms".

"Our strongest recommendation is that people need to go back to statins," Krumhotz said. "We really think there's just a small group of patients who cannot get to target (cholesterol) on statins."

"He said doctors should maximize the doses of statins and then try adding other drugs such as niacin-based drugs or fibrates in an attempt to lower LDL cholesterol levels as current practice guidelines recommend".

Panel: Doctors Should Cut Vytorin, Zetia Use



In the classic explanation of the dangers of high cholesterol, high cholesterol leads to the narrowing of the coronary arteries and a plaque may break off and block or occlude the artery. The result is little or no blood flow to the part of the heart being supplied by that artery and a heart attack. As Dr. Peter Libby of Harvard points outsometimes a plaque grows so large that it virtually halts the blood flow in an artery and generates a heart attack or stroke.





Some doctors like Zetia because it works in the intestine to block cholesterol absorption, not in the liver like statins. So potentially it has fewer side effects. But now the question is should they prescribe Zetia if it doesn't help with artery plaques?




"Previous studies have shown Zetia and Vytorin are effective at lowering cholesterol, but other medications that do this have been shown to have additional benefits, such as slowing the buildup of plaque or sometimes even shrinking it, and reducing the risk of heart attacks and strokes and lowering mortality rates".

Journal Issues Warning on Two Cholesterol Drugs