Jennifer Loftus did everything she could think of to bring down her high cholesterol. But nothing - not diet, not exercise, not even natural supplements - helped her control the problem.
After six years of trying, the otherwise healthy 36-year-old nurse from Marlton was ready to take her doctor's advice: start a lifelong, daily regimen of cholesterol-lowering statins.
It's what millions of Americans do - turning statins into huge moneymakers for drug companies.
The cholesterol-lowering drugs have been shown in clinical studies to reduce the risk of death, heart attack and other problems in patients with cardiovascular disease, but it is less clear that they help patients such as Loftus who don't yet have heart disease.
"It is a very common response - not just of primary-care doctors, but also cardiologists - that everybody with high cholesterol is put on a statin," said David Becker, a Flourtown cardiologist.
Becker thinks that quick-fix approach has led to the drugs' overprescription.
Now a recent study that compared two cholesterol drugs has many patients and doctors asking the same thing.
The study compared the combination drug Vytorin - a mix of two cholesterol busters, Zetia and Zocor - to Zocor alone. It found that Vytorin did not do better than Zocor in preventing the buildup of arterial plaque.
Vytorin is made by a Merck and Schering Plough partnership aimed at adding a new cholesterol drug to the market as Merck's Zocor went generic. Zetia blocks cholesterol absorption in the stomach, while Zocor limits cholesterol production in the liver.
The buildup of plaque from too much cholesterol can lead to heart attack and stroke. It has long been assumed that by lowering cholesterol, patients would lessen their risk of death - even in people without heart disease.
But analyses of studies that compare otherwise healthy patients on statins with those not taking the drugs reveal that dozens of people must be treated with the medications over many years to avoid a single heart attack or other "major coronary event."
Between 200 and 250 people with high cholesterol but no known cardiovascular disease must take the drugs daily for three to five years to prevent one death, two analyses of the available scientific literature reveal.
On the other hand, if 68 such patients followed a more careful diet, one death could be avoided, according to a similar analysis that tracked patients for an average of more than 61/2 years.
