Diet Still Important to Patients on Cholesterol-Lowering Drugs

THURSDAY Aug. 16, 2007 -- Patients taking cholesterol-busting statins usually eat healthy, too, a new study finds.

The finding contrasts with what many doctors believe: that patients view drugs such as Lipitor, Pravachol and Zocor as a license to eat whatever they like because they think the medication is enough to protect them from heart disease.

"We went into this study thinking that these medications are so good, and changing your diet is so hard, that we expected people to relax their dietary efforts, increasing their fat intake," said lead researcher Dr. Devin Mann, of the Mount Sinai School of Medicine in New York City.

But that wasn't as big a problem as many people assumed, Mann said. "In reality, we often have expectations of what behavior will be. But you actually have to look and check, because behavior is tricky -- it's hard to predict," he said.

In the study, which is published in the August issue of Mayo Clinic Proceedings, Mann's team collected data on 71 patients taking statins to prevent heart disease. The researchers interviewed them when they started on the drug, and again three and six months later.

The researchers found there was no significant change in how much saturated fat the patients included in their diets.

"As doctors, we have assumptions of what behaviors will be like, but we often don't get what the opinions of the patients really are," Mann said. "It was surprising how many people, even if they thought diet wasn't going to be effective, still wanted to do it," he said.

Given these findings, Mann believes doctors should continue to pursue lifestyle changes with their patients. "We shouldn't give up on lifestyle just because we are starting drug therapy -- these things should really work together," he said.

Patients already understand this, Mann said. Doctors should encourage patients to make lifestyle changes and not think it's a waste of time, he noted.

Mann also believes that patients need to tell their doctors what they think about the medications and lifestyle changes that are being recommended.

"Patients and doctors should work from common ground to make decisions, because if you make decisions without information, you make poorly informed decisions," Mann said.

One expert was encouraged by the findings.

"Achieving and maintaining healthy lipid levels is essential for prevention of cardiovascular events and premature death," said Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles. "Many patients require both dietary modification and lipid-lowering medications to get to recommended lipid levels."

Unfortunately, study after study shows that many adults in the United States are not being adequately treated for their cholesterol levels and thus having cardiovascular events that could have been prevented, Fonarow noted.

"While many patients do not adhere to their medical regimen, missing doses or stopping altogether, little was known about whether starting lipid-lowering medications would adversely influence adherence to dietary recommendations," Fonarow said. "The results of this study -- showing no significant change in reported dietary habits after initiation of statin treatment -- should be reassuring to physicians and other health-care providers."

Posted: August 2007


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