Statins may improve erectile function in men with high cholesterol

Statins can not only lower cholesterol and decrease risk of heart attack and stroke, but if you are an older man, then they may also improve your sexual health, new research finds.

Erectile dysfunction is often experienced by older men who have poor cardiovascular health, diabetes or metabolic syndrome. In fact, erectile dysfunction could be interpreted as a warning sign of cardiovascular disease.

It is "similar to a canary in a coal mine," according to Dr. John B. Kostis, author of the new study and director of the Cardiovascular Institute at Robert Wood Johnson Medical School in New Brunswick, NJ.

Statins are prescribed to lower cholesterol. They work by blocking substances that the body needs to make cholesterol. They also help to reabsorb cholesterol that has built up in plaques on the artery walls, which prevents further blockage in the blood vessels.

Doctors believe that statins may be effective in treating conditions other than high cholesterol. Medical conditions for which doctors think statins may have beneficial applications include:

• Arthritis and bone fractures
• Some forms of cancer
• Dementia and Alzheimer's disease
• Kidney disease
• Controlling the body's immune system after an organ transplant.

In 2013, Medical News Today reported on a study in the journal Annals of Surgery that suggested statins could help prevent cognitive decline after surgery.

But more research is needed to explore what other benefits this class of drugs may provide.

Meta-analysis of 11 randomized controlled trials

Doctors believe that statins may be effective in treating conditions other than high cholesterol, but more research is needed.

Dr. Kostis and his team reviewed the data of 11 randomized controlled trials on erectile dysfunction and statins.

Presenting the team's findings simultaneously at the American College of Cardiology's Annual Scientific Session and in the The Journal of Sexual Medicine, Dr. Kostis says:

"Our research indicates that statins not only improve cardiovascular health and reduce the risk of stroke and heart attack, but also improve erectile function in the men included in our analysis."

He warns, though, that statins should not be prescribed for erectile dysfunction without symptoms of cardiovascular disease, or when erectile dysfunction may be caused by psychosocial factors.

Dr. Kostis says this is because further study is still required to fully understand the link between statin therapy and improvement of erectile function.

He adds:

"Ultimately, a healthy lifestyle is the best method to prevent disease, including erectile dysfunction. But statin therapy has been proven to provide long-term benefits in reducing cardiovascular disease and the detrimental consequences associated with it. Offering statin therapy to improve erectile function may extend these benefits further."

Although statins are very effective at lowering cholesterol, they do have some potentially serious side effects. These include liver damage, muscle problems, increased blood sugar or type 2 diabetes, and neurological side effects - such as memory loss or confusion.

Read More: http://www.medicalnewstoday.com/articles/274830.php

Findings underscore the importance of universal pediatric cholesterol screening

Roughly one out of three kids screened for high cholesterol between the ages of 9 and 11 has borderline or high cholesterol, potentially placing them at greater risk for future cardiovascular disease, according to research to be presented at the American College of Cardiology's 63rd Annual Scientific Session.

In one of the largest studies of outpatient pediatric clinic visits to date, researchers examined the medical records of 12,712 children who had screening for cholesterol levels as part of a routine physical exam within the Texas Children's Pediatrics Associates clinics, the nation's largest pediatric primary care organization. Of these, 4,709, or 30 percent, had borderline or elevated total cholesterol as defined by the National Cholesterol Education Program.

"The sheer number of kids with abnormal lipid profiles provides further evidence that this is a population that needs attention and could potentially benefit from treatment," said Thomas Seery, M.D., pediatric cardiologist at Texas Children's Hospital, assistant professor of Pediatrics at Baylor College of Medicine, and the lead investigator of the study. "But we can only intervene if we diagnose the problem."

While cardiovascular disease in children is rare, the presence of certain risk factors in childhood can increase the chances of developing heart disease as an adult. Previous studies have demonstrated that atherosclerosis - a hardening and narrowing of the arteries - can begin in childhood.

"We know that higher levels of, and cumulative exposure to, high cholesterol is associated with the development and severity of atherosclerosis," Seery said. "If we can identify and work to lower cholesterol in children, we can potentially make a positive impact by stalling vascular changes and reducing the chances of future disease." He said that this is especially important amid the growing obesity epidemic, which is resulting in a larger population of children with dyslipidemia, an abnormal amount of cholesterol or fats in the blood.

In this study, researchers also found that boys were more likely than girls to have elevated total cholesterol, low-density lipoprotein (LDL), or "bad" cholesterol, and triglycerides, while girls had lower high-density lipoprotein (HDL) or "good" cholesterol. Obese children were more likely to have elevated total cholesterol, LDL and triglycerides, with lower HDL in comparison to non-obese children. Average total cholesterol, LDL, non-HDL and HDL were all within the normal range, 162 mg/dL, 92 mg/dL, 113 mg/dL and 52 mg/dL, respectively; mean triglycerides were borderline or abnormal (103 mg/dL). Similar to a recent, unrelated study of adult minority groups, 9- to 11-year-old Hispanic children in this study were more likely to have elevated triglycerides and lower HDL when compared to non-Hispanics.

The authors said they hope their findings will give added weight to guidelines sponsored by the National Heart Lung and Blood Institute and endorsed by the American Academy of Pediatrics that call for universal cholesterol screening of children between the ages of 9 and 11 years and, again between 17 and 21 years of age. Despite these recommendations, some practitioners remain hesitant.

"There is concern by some in the medical community that children will be started on medication unnecessarily," Seery said, emphasizing that adopting a healthy diet and engaging in routine physical activity are first-line therapies for children with abnormal cholesterol levels.

He adds that cholesterol-lowering medications are typically needed in one to two percent of children with dyslipidemia, primarily in those with very high cholesterol resulting from a genetic lipoprotein disorder. Genetic lipoprotein disorders, such as familial hypercholesterolemia, result in very high cholesterol levels that can be detected in childhood but are felt to be underdiagnosed, he said.

Read More: http://www.medicalnewstoday.com/releases/274773.php

Children in the US: 1 in 3 may have high cholesterol

Approximately 1 in 3 children in the US may have borderline or high cholesterol, according to a new study recently presented at the American College of Cardiology's 63rd Annual Scientific Session.

The research team, led by Dr. Thomas Seery, pediatric cardiologist at Texas Children's Hospital and assistant professor at Baylor College of Medicine in Texas, analyzed the medical records of 12,712 children aged between 9 and 11 years who were screened for cholesterol levels during a routine physical examination at Texas Children's Pediatrics Associates clinics.

Of these children, 30% (4,709) were found to have high cholesterol (200 mg/dL or more) in line with definitions from the National Cholesterol Education Program.

In detail, the researchers found that boys were more likely to have higher total cholesterol, higher low-density lipoprotein (LDL) - known as "bad" cholesterol - and higher levels of triglycerides (a type of fat found in blood) than girls. Girls had lower high-density lipoprotein (HDL), or "good" cholesterol, than boys.

Children who were obese were more likely to have higher total cholesterol, higher LDL, higher triglyceride levels and lower HDL than children who were not obese, while Hispanic children were more likely to have higher triglyceride levels and lower HDL than non-Hispanic children.

Average total cholesterol of the group was within the normal range, as was LDL, non-HDL and HDL. Mean triglyceride levels were borderline or abnormal.

Evidence that children 'need attention and treatment' for high cholesterol

Researchers say their findings stress the importance of cholesterol-reducing interventions, such as a healthy diet and exercise, to help reduce later-life disease risk.

High cholesterol is a main risk factor for cardiovascular disease (CVD). Although it is rare for a child to develop CVD, high cholesterol may significantly increase their risk for the condition later in life.

According to the American Heart Association, there is evidence that high cholesterol levels in early life can also lead to atherosclerosis in adulthood - the build-up of fatty plaques in the arteries that can lead to heart disease.

With these risks in mind, the fact that this latest research reveals that 1 in 3 children has high cholesterol is alarming.

Dr. Seery notes that the growing obesity epidemic adds to this concern. Childhood obesity has more than doubled in the past 30 years, but with increasing rates of obese children comes an increasing number of children with dyslipidemia - an abnormal amount of cholesterol or fats in the blood.

Dr. Seery comments:

"The sheer number of kids with abnormal lipid profiles provides further evidence that this is a population that needs attention and could potentially benefit from treatment.

If we can identify and work to lower cholesterol in children, we can potentially make a positive impact by stalling vascular changes and reducing the chances of future disease."

Should all children undergo cholesterol screening?

Current guidelines form the National Heart, Lung and Blood Institute, which are supported by the American Academy of Pediatrics, call for all children to undergo cholesterol screening between the ages of 9 and 11 years, and again between 17 and 21 years. But Dr. Seery says that there is some concern in the medical community that these recommendations will lead to many children being prescribed medication that they may not need.

However, he notes that around 1-2% of children with dyslipidemia require cholesterol-lowering medications, and these children tend to be those who have very high cholesterol levels as a result of genetic lipoprotein disorders.

Dr. Seery stresses that the first port of call to reduce abnormal cholesterol levels in children is encouraging them to adopt a healthy diet and engage in regular exercise.

Overall, the research team says their findings provide a "compelling" reason to screen all children for cholesterol levels.

Read More: http://www.medicalnewstoday.com/articles/274882.php

Inherited high cholesterol often goes underdiagnosed and undertreated

An estimated 1 in 500 people worldwide suffer from familial hypercholesterolaemia (FH), an inherited condition of extremely highcholesterol that is associated with prematureheart disease and death. Despite this high prevalence, recent research funded by the Minneapolis Heart Institute Foundation (MHIF) confirms FH is underdiagnosed and undertreated. Thomas Knickelbine, MD, Preventive Cardiology Director at the Minneapolis Heart Institute at Abbott Northwestern Hospital, presented the results of research aimed at identifying just how prevalent FH underdiagnosis is at the American College of Cardiology (ACC) meeting in Washington, DC.

Dr. Knickelbine and a team of MHIF researchers analyzed the electronic health records (EHRs) of 391,166 consenting ambulatory patients seen at Allina Health locations between 2009 and 2012 to identify individuals who were at least 80% likely to have FH (determined by low-density lipoprotein [LDL or "bad" cholesterol"] levels and age). They discovered 841 patients (0.21% or 1 in ~465) who were likely to have FH - only 36 (4.3%) of them had been diagnosed with the condition. "Provider recognition of FH is extremely low," explains Dr. Knickelbine. "Our research shows we can effectively use EHR data to identify asymptomatic FH patients and improve early diagnosis and treatment of this high-risk condition."

In this large, ambulatory patient population, the researchers also found that FH was undertreated. Of the 841 patients likely to have FH, 64.8% were on statin medications, but an additional 25.8% were not currently on a statin nor were they reported to be statin intolerant. In addition, only about one fourth of the identified FH group had achieved their NCEP LDL goal, and only 31% had been seen by a cardiovascular (CV) specialist.

Read More: http://www.medicalnewstoday.com/releases/274852.php

LDL cholesterol safely dropped well below statin-only baseline with evolocumab

The monoclonal antibody evolocumab produced highly significant reductions in low-density lipoprotein (LDL) cholesterol, the "bad cholesterol," as an add-on to statins in all treatment groups, according to data from the LAPLACE-2 study presented at the American College of Cardiology's 63rd Annual Scientific Session.

LDL cholesterol is considered a major risk factor for cardiovascular disease. "High-risk patients - such as those with clinical cardiovascular disease, high LDL cholesterol levels or diabetes - are ideally treated with high-intensity statins that lower LDL cholesterol by at least 50 percent, but that isn't always possible," said Jennifer G. Robinson, M.D., M.P.H., director of the Prevention Intervention Center at the University of Iowa College of Public Health.

"Many patients can't tolerate high-intensity statins and cannot achieve desired LDL reductions with moderate- or low-intensity statins, and those with high cholesterol levels often need more than high-intensity statins to lower LDL levels adequately." Robinson said evolocumab may be useful for these patients.

Unlike statins, which are taken in pill form, evolocumab is administered as an injection.

LAPLACE-2 is a large phase III study of evolocumab in patients randomly assigned to a high- or moderate-intensity statin to reduce LDL cholesterol. Evolocumab works by inhibiting PCSK9, which leads to an increase in the liver's ability to clear LDL cholesterol from the blood. High-intensity statins such as 80-mg atorvastatin and 40-mg rosuvastatin lower LDL by 50 percent or more; moderate-intensity statins such as 40-mg simvastatin, 10-mg atorvastatin and 5-mg rosuvastatin drop LDL levels by 30 to nearly 50 percent. Evolocumab was also compared with ezetimibe, another drug commonly used to lower LDL cholesterol. After a four-week period to stabilize lipids with one of these five statin regimens, 1,899 patients were randomly assigned to different doses and schedules of evolocumab or placebo, evolocumab and placebo, placebo and ezetimibe, or placebo only.

All evolocumab-treated groups showed highly significant reductions in LDL cholesterol versus placebo: 66 percent to 75 percent on a schedule of evolocumab injections every two weeks, or 63 percent to 75 percent on a four-week schedule. Patients achieved an LDL cholesterol level of less than 70 mg/dL in 86 percent to 94 percent in the moderate-intensity statin groups and 93 percent to 95 percent in the high-intensity groups. Ezetimibe reduced LDL cholesterol by 17 percent to 20 percent in moderate-intensity statin groups and 51 percent to 62 percent in high-intensity groups. Adding evolocumab reduced LDL cholesterol levels to 39 mg/dL to 49 mg/dL with moderate-intensity statin regimens and 33 mg/dL to 39 mg/dL with high-intensity regimens. Evolocumab also significantly reduced non-HDL cholesterol, apolipoprotein B and lipoprotein (a) levels.

Efficacy and safety endpoints were met. Evolocumab was well tolerated, with adverse event rates similar to those in placebo and ezetimibe-treated groups and no sign of liver damage or muscle problems.

"Heart attack and stroke remain the leading cause of death in the United States and around the world," Robinson said. "People are excited about PCSK9 inhibitors because they'll let us test whether a whole lot more LDL lowering will result in large additional reductions in cardiovascular events in statin-treated patients."

The ongoing FOURIER trial will assess whether additional lowering of LDL cholesterol with evolocumab, on top of high- and moderate-intensity statin therapy, reduces the number of cardiovascular events over a period of years.

Read More: http://www.medicalnewstoday.com/releases/274850.php

Glial cell line-derived neurotrophic factor could help the body resist weight gain

In a new study, Simon Musyoka Mwangi and colleagues tested whether higher levels of a certain protein help fight the weight gain and health problems caused by eating the wrong foods.

More than one-third of people in the US are obese. Obesity and its related health problems - including high blood pressure, high cholesterol, diabetes, insulin resistance, and belly fat - affect so many, yet effective treatments are very few.

Glial cell line-derived neurotrophic factor - or GDNF for short - is a protein integral to keeping the body's systems in balance (homeostasis) and helping develop and maintain the nerve cells responsible for a host of bodily functions such as digestion and muscle control. Previous research has shown that elevated levels of GDNF can lead to weight loss in rodents and primates with age-related obesity and prevent weight gain in younger animals. In this study, researchers looked specifically at how the increased presence of GDNF might affect obesity caused by a high fat diet.

Researchers compared mice bred to have higher levels of GDNF protein with control mice. The mice were fed either a regular rodent diet (containing ~6% fat) or a high-fat diet (~34% fat).They found that the GDNF-mice fed a high-fat diet resisted diet-induced weight gain, visceral (around the organs) fat development, fatty liver, high lipid (fat) levels in the blood, and insulin resistance. The GDNF mice also experienced improved insulin sensitivity and increased calorie burn compared to control mice on a high-fat diet.

More research is needed into how GDNF works in the body, but the data presented by Mwangi et al. suggest that it may cause increased calorie burn in both brown and white fat cells and in muscle tissue. Their research also suggests that GDNF and its receptors may be unique and effective targets for obesity prevention and treatment therapies.

Read More: http://www.medicalnewstoday.com/releases/274957.php

Eat one daily serving of legumes to keep away 'bad cholesterol'

Chickpeas, beans, lentils or peas can keep away "bad cholesterol" with just one serving per day, according to a new study published in CMAJ.

Low-density lipoprotein (LDL) cholesterol is one of the most important risk factors for cardiovascular disease. The reason for its importance? Because it can be avoided by simple dietary modifications.

Non-oil-seed pulses, such as beans, chickpeas, lentils and peas, are already recommended as part of dietary guidelines to prevent major chronic diseases. A large observational study has also linked consumption of these pulses with lower LDL cholesterol levels.

The new study, by Canadian researchers at St. Michael's Hospital, Toronto, was intended to improve the evidence on which these dietary guidelines are based.

To do this, the researchers conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effects of pulse consumption on reducing LDL cholesterol.

The review drew its data from 26 RCTs, looking at 1,037 people altogether. Overall, the review found that people who ate one serving (3/4 cup) of non-oil-seed legumes a day exhibited a 5% reduction in LDL cholesterol.

"The reduction of 5% [LDL cholesterol] in our meta-analysis suggests a potential risk reduction of 5-6% in major vascular events," writes co-author Dr. John Sievenpiper.

The study also found a greater reduction in LDL cholesterol in men than women. The researchers think this might be because men generally have poorer diets and higher cholesterol than women, so they show greater improvements from a healthier diet.

Despite the reduction in LDL cholesterol, some participants did experience minor side effects from the diet, such as bloating, flatulence, diarrhea or constipation. However, the researchers write that the suggested one serving a day "is currently consumed by many cultures without reports of adverse effects that would limit consumption."

North Americans 'have a lot of room in their diets to increase pulse intake'

People who ate one serving (3/4 cup) of non-oil-seed legumes a day exhibited a 5% reduction in LDL cholesterol.

The researchers acknowledge though that legume intake in many Western countries, such as Canada and the US, is quite low.

"Canadians have a lot of room in their diets to increase their pulse intake and derive cardiovascular benefits," states Dr. Sievenpiper. "Only 13% consume pulses on any given day, and of those who do, the average intake is only about a half serving."

As well as improving LDL cholesterol, the researchers also believe that eating legumes every day could have other beneficial effects that may protect against cardiometabolic problems. These could include improving body weight, blood pressure and glucose control.

However, this study had some limitations. The study periods of the RCTs within this systematic review were all shorter than 3 months and did not report enough data to safeguard against a risk of bias. More high-quality evidence is needed to confirm the positive effects of legumes in lowering LDL cholesterol.

Read More: http://www.medicalnewstoday.com/articles/275179.php