Zetia/Vytorin Study: A Perspective

You may have heard the considerable debate regarding the cholesterol-lowering medication, Zetia. Unlike statins which affect your cholesterol production, this drug blocks the absorption of both dietary and biliary (liver-produced) cholesterol into the blood stream. The drug is intended to provide individuals who cannot reduce LDL cholesterol using diet and exercise with an alternative to high dosages of statin medications. It also was developed for those who simply cannot tolerate statins.

In a recent controversial study reported in the New England Journal of Medicine, the effects of taking Zetia and the statin, Zocor, combined (together known as the drug Vytorin) was compared to the effects of taking Zocor only.

Here are results:

The group taking the two drugs experienced an LDL cholesterol decline that was 27% greater than the Zocor-only group.

Despite the increased lowering of LDL cholesterol in the group that received both medications, both groups saw arterial plaque build at rate that was similar (although those on the combination drug saw a somewhat larger, but not statistically significant, increase).

This finding is at odds with our traditional understanding of the favorable relationship between lower LDL cholesterol and atherosclerosis.

The trial, however, did not directly address whether lowering of LDL cholesterol with the combination drug reduces heart attacks, strokes and other cardiovascular “events.” The combination drug may or may not provide an additional benefit.

So how is the medical community responding?

An editorial in the New England Journal of Medicine observes that “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,” leaving Zetia for special situations. Yet, well trained, qualified doctors continue to prescribe the combination drug more broadly, believing that a single study does not unseat established wisdom.

The human body is profoundly complex, and we simply do not know with certainty how any particular approach will affect our long term health and longevity. We can only play the odds as we know them today. This requires that each of us take an educated approach to our health. Kardea aims to enable the members of its community to make more informed decisions about cholesterol management and natural nutrition.