吃完大餐後來一顆statin加bokey吧!

I'll Have a Statin with My Burger

Can a single statin dose counteract the cardiovascular risk conferred by an unhealthy meal?

Daily doses of statins reduce the relative risk for myocardial infarction by 20% to 70%. In contrast, reductions in cardiovascular risk associated with decreasing dietary fat intake have not always been statistically significant. Interventional studies to examine whether taking statins can mitigate the harmful effects of an unhealthy diet are unlikely to take place. Therefore, investigators used a meta-analysis of seven randomized controlled trials (42,848 patients) of statins for primary prevention of coronary artery disease and data from a cohort study of the effects of dietary fat on cardiovascular risk (43,757 men) to calculate a "neutralization tariff" with the following assumptions:

  • Each unhealthy meal consumed contributes to an increase in cardiovascular risk.
  • Each statin tablet taken contributes to a decrease in risk.
  • No high-risk patient group has been identified in whom statins appear to be ineffective.
  • If the beneficial effects of one statin dose and the harmful effects of one unhealthy meal are approximately equal, the mechanisms or timing of the two effects need not correlate directly.

By plotting the logarithm of the reduction in relative cardiovascular risk associated with statins in different trials against the logarithm of the increase in relative risk associated with the consumption of fast foods high in total fat and trans-fat, the investigators found that most daily statin regimens can offset the increased relative risk of eating a Quarter Pounder with cheese and a small milkshake.

Comment: According to this provocative analysis, most statin doses could neutralize the ill effects of an unhealthy meal. The adoption of a healthy diet is a cornerstone of any strategy for primary prevention of heart disease. However, many patients at high cardiovascular risk fail to achieve the necessary lifestyle modifications. Would providing statins with fast foods decrease the overall burden of heart disease in the world?

— Joel M. Gore, MD

Published in Journal Watch Cardiology September 22, 2010

Citation(s):

Ferenczi EA et al. Can a statin neutralize the cardiovascular risk of unhealthy dietary choices? Am J Cardiol 2010 Aug 15; 106:587.

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