Cholesterol test fasting "largely unnecessary" (Canada)

Fasting before getting a blood test of cholesterol levels may be unnecessary, a new Canadian study suggests. Current guidelines suggest taking blood samples for lipid tests like high-density lipoprotein or HDL cholesterol after fasting for nine to 12 hours, but the requirement isn't always practical for patients. Fasting for routine blood work may discourage patients from going for the tests and blood labs may have long wait times in the morning that inconvenience people even more. In the Archives of Internal Medicine, Dr. Davinder Sidhu and Dr. Christopher Naugler of the University of Calgary looked at how long 209,180 people in Calgary fasted and their lipid results. Last year, the city's laboratory service changed its policy allowing samples to be processed regardless of the fasting time. "We found that fasting time showed little association with lipid subclass levels in a large community-based cohort," the study's authors concluded. "This finding suggests that fasting for routine lipid level determinations is largely unnecessary."

Low "good" cholesterol doesn't cause heart attacks

Despite plenty of evidence that people with low levels of "good" cholesterol are more prone to heart attacks, a large new study suggests that the lacking lipid is not to blame. The analysis of data on nearly 70,000 people in Denmark affirmed the link between low levels of high-density lipoprotein (HDL), the so-called "good" cholesterol, and raised heart attack risk in the general population. But in people with a gene mutation that lowers HDL, heart attack risk was not found to be higher at all. "Association itself doesn't mean causality," said lead author Dr. Ruth Frikke-Schmidt, a consultant in the Department of Clinical Biochemistry at Rigshospitalet in Copenhagen. The results, published in the Journal of Clinical Endocrinology and Metabolism, indicate that just having low HDL is not what raises the likelihood of a heart attack

Pill may boost HDL 'good' cholesterol

Once again, an experimental pill that boosts levels of HDL "good" cholesterol has shown promising results in a mid-stage study. In a three-month study of nearly 400 people, the drug evacetrapib raised HDL and lowered LDL, the so-called "bad cholesterol" - both when given alone and with standard cholesterol-lowering statin drugs. Importantly, evacetrapib did not routinely increase blood pressure or produce any of the other toxic effects that halted development of its predecessor, torcetrapib. The big question, however, is whether raising levels of good cholesterol will prevent heart attacks, strokes, and deaths, says Robert Harrington, MD, of Duke University Medical Center in Durham, N.C. He was not involved with the study, but has consulted for the maker of another HDL-boosting drug

New therapy shows promise for treating cardiovascular disease

A new therapy being studied in non-human primates by researchers at Wake Forest Baptist Medical Center and colleagues is demonstrating promise as a potential tool for combating cardiovascular disease by increasing good cholesterol and lowering triglycerides in the blood. Supported by the National Institutes of Health and the Canadian Institutes of Health Research, the preclinical findings appear in a recent issue of the journal Nature. "The study was conducted because there is a very strong inverse correlation between the amount of HDL (good cholesterol) and heart disease," said co-principal investigator Ryan Temel, Ph.D., an assistant professor of pathology and lipid sciences at Wake Forest Baptist. "The higher your level of HDL, the lower your risk of developing cardiovascular disease. Currently, however, there are few therapies that significantly raise HDL."

Gut bacteria may affect whether a statin drug lowers cholesterol

Statins can be effective at lowering cholesterol, but they have a perplexing tendency to work for some people and not others. Gut bacteria may be the reason. A research team led by a Duke University scientist has identified three bile acids produced by gut bacteria that were evident in people who responded well to a common cholesterol-lowering drug called simvastatin. The finding, published Oct. 13, 2011, in PLoS One, demonstrates how gut bacteria can cause inherent differences in the way people digest, metabolize and benefit from substances such as drugs. The study represents the intersection of two emerging research interests: An analysis of the intestinal microflora, plus the use of a science called metabolomics, which examines the thousands of biochemical components involved in cellular metabolism and how they affect health

FDA OKays combo pill for diabetes, cholesterol

The FDA has approved a fixed-dose combination tablet that combines the diabetes drug sitagliptin with simvastatin, under the brand name Juvisync. It's the first product with drugs for diabetes and high cholesterol in a single pill, the agency noted. Sitagliptin is a DPP-4 inhibitor sold as Januvia, first approved in 2006 as an adjunct to diet and exercise. Simvastatin (Zocor) is one of the most popular statin drugs for reducing total and LDL cholesterol. In the short term, the combination product will come in three strengths, all with 100 mg of sitagliptin and 10, 20, or 40 mg of simvstatin. The FDA advised physicians to consider other drugs that patients may be taking when deciding which strength to prescribe. The product's manufacturer, the Merck subsidiary MSD International GmbH Clonmel, of Tipperary, Ireland, has committed to develop additional strengths with 50 mg of sitagliptin and 10, 20, and 40 mg of simvastatin, according to the agency. "Pending availability of the fixed-dose combination tablets containing 50 mg of sitagliptin, patients who require this dose should continue to use the single ingredient sitagliptin tablet," the FDA said. Sitagliptin is also sold in a 25-mg dose, but it is seldom prescribed and there are no plans to develop Juvisync tablets with that dose, the agency added. The FDA noted that statins can exacerbate hyperglycemia in patients with type 2 diabetes. "This risk appears very small and is outweighed by the benefits of statins for reducing heart disease in diabetes," the agency said. "However, the prescribing information for Juvisync will inform doctors of this possible side effect. The company will also be required to conduct a post-marketing clinical trial comparing the glucose-lowering ability of sitagliptin alone compared to sitagliptin given with simvastatin." Common side effects associated with the combination include upper respiratory infections, rhinitis, sore throat, headache, muscle and stomach pain, constipation, and nausea. (You may wish to consult your own medical expert about this)

High cholesterol might be linked to Alzheimer's Disease

New research suggests that high cholesterol levels could boost the risk of Alzheimer's disease by creating more brain-clogging bits known as plaque. The finding doesn't directly prove that high cholesterol causes Alzheimer's disease or that lowering it would reduce the risk. Also, researchers didn't find any link between high cholesterol and tangles, which also clog the brain in those with Alzheimer's. Still, the findings add to previous research that has linked insulin resistance to Alzheimer's disease, said study author Dr. Kensuke Sasaki. Better control of both cholesterol levels and insulin resistance, both risk factors for heart disease, "might contribute to a strategy for the prevention of Alzheimer's disease," said Sasaki, an assistant professor of neuropathology at Kyushu University in Japan

Fructose may up heart disease risk factors (USA)

Adults who ate high fructose corn syrup for two weeks increased their cholesterol and triglycerides levels, U.S. researchers say. Kimber Stanhope of the University of California, Davis, says the American Heart Association recommends that people consume only 5 percent of calories as added sugar. The Dietary Guidelines for Americans 2010 suggest an upper limit of 25 percent or less of daily calories consumed as added sugar. In this study, researchers examined 48 adults ages 18-40 and compared the effects of consuming 25 percent of one's daily calorie requirement as glucose, fructose or high fructose corn syrup on risk factors for cardiovascular disease. Study participants consumed high fructose corn syrup as 25 percent of their daily calories - UPI

Cholesterol drugs could cut clots

"Drugs which can regulate levels of cholesterol in the blood may also reduce the risk of dangerous clots, say scientists. Blood clots can result in stroke or heart attack. Researchers, writing in the journal Blood, reduced the size and stability of blood clots in mice and said the discovery could lead to new drugs. The British Heart Foundation said it was an exciting discovery which could result in more effective treatments. Around 32,000 people in the UK die after developing a blood clot. The team at the University of Reading was investigating how clots form and say they were surprised to find that protein, LXR, was involved. LXR is already known to control levels of cholesterol and drug companies have been targeting it for new treatments"

From dusty punch cards, new insights into link between cholesterol and heart disease

"A stack of punch cards from a landmark study published in 1966, and the legwork to track down the study's participants years later, has yielded the longest analysis of the effects of lipoproteins on coronary heart disease. The study, published in a recent issue of the journal Atherosclerosis, tracked almost 1,900 people over a 29-year period, which is nearly three times longer than other studies that examine the link between different sizes of high-density lipoprotein particles and heart disease. It found that an increase in larger high-density lipoprotein particles decreased a subject's risk of heart disease. The research also underscores the value of looking to the past to advance science"

Quitting smoking linked to lower levels of 'bad' cholesterol

"Smokers who successfully quit may enjoy yet another health benefit: improved cholesterol profiles. A boost in "good" cholesterol comes with quitting despite weight gain after putting out the last cigarette, hints a new study. If confirmed in future research, the finding could shed light on the strong, yet somewhat mysterious relationship between smoking and heart health. Up to 20% of heart disease deaths are currently blamed on smoking, but researchers haven't yet had a clear understanding of what lies behind the effect. Smoking likely affects the cardiovascular system in a variety of ways, including lowered oxygen levels and wear and tear on the heart itself. Some small studies have also shown that smoking lowers good cholesterol (HDL) and raises bad cholesterol (LDL), lead researcher Dr. Adam Gepner of the University of Wisconsin School of Medicine and Public Health, in Madison, told Reuters Health

Diabetes may clamp down on cholesterol the brain needs (USA)

The brain contains more cholesterol than any other organ in the body, has to produce its own cholesterol and won't function normally if it doesn't churn out enough. Defects in cholesterol metabolism have been linked with Alzheimer's disease and other neurodegenerative conditions. Now researchers at Joslin Diabetes Center have discovered that diabetes can affect how much cholesterol the brain can make. Scientists in the laboratory of C. Ronald Kahn, M.D., head of Joslin's Integrative Physiology and Metabolism research section, found that brain cholesterol synthesis, the only source of cholesterol for the brain, drops in several mouse models of diabetes. Their work was reported online in the journal Cell Metabolism on November 30

Merck drug for cutting cholesterol is promising (USA)

"Merck has a potential blockbuster in anacetrapib, an experimental cholesterol drug that increases HDL, or 'good' cholesterol even as it lowers LDL, the 'bad' cholesterol. The drug could potentially have sales of more than $1 billion a year, John Boris, an analyst at Citigroup, wrote in a note to investors on Wednesday. But don't hold your breath. Cardiologists, patients and investors will have to wait until at least 2015 to find out whether anacetrapib protects the heart by reducing heart attacks and other cardiovascular problems, Merck said. Anacetrapib works by inhibiting an enzyme called CETP, which is involved in transforming particles of good cholesterol into bad cholesterol" - New York Times

Low cholesterol, depression linked (Netherlands)

"Low cholesterol levels may have a big downside: severe depression, scientists say. A study of 260 men from the Netherlands shows those with chronically low cholesterol readings are more likely to suffer symptoms of severe depression. The study appears in the journal Psychosomatic Medicine. Researchers divided the 40- to 70-year-old men into those who had low cholesterol and those who maintained a slightly more moderate level. The study shows the relative risk of having severe depressive symptoms was four to seven times higher in the men with chronically low cholesterol levels. Researchers found no difference, however, in the levels of hostility or impulsiveness in either group. Recent weight loss and lower calorie intake also are associated with a higher risk of depressive symptoms, the researchers say. Dr. Diederick Grobbee, chairman of the Julius Center for Patient Oriented Research, University Medical Center, Utrecht, The Netherlands, says there are few studies in this area. He adds because there is so little research, the reasons low cholesterol influences the depressive symptoms remain unknown"

Early cholesterol problems spell trouble for middle-aged arteries

"Researchers say too much cholesterol isn't safe - at any age. And a recent study suggests it really does matter what you eat and how much you exercise in your 20s and 30s. How come? A heart-healthy diet and regular exercise can lower LDL, or "bad" cholesterol. That's the stuff that can really clog up arteries that feed the heart. And, it turns out, the clogging process starts early. So it's never too soon to start being nicer to your heart. Seems obvious, right? But researchers say the medical community hasn't fully appreciated the consequences of high cholesterol during young adulthood. Now, though, a study in the Annals of Internal Medicine sheds some interesting light on how plaques build up" - GBP News

Scots' cholesterol research could be life-saver

Scottish scientists have discovered new genes linked to high cholesterol, paving the way for tests to predict a person's risk of heart disease. An international team of researchers, including experts at Edinburgh University, studied the genetic make-up of more than 100,000 volunteers to help to pinpoint genes which might have an impact on cholesterol levels. The scientists said the study showed for the first time that it was possible to predict who was likely to develop high cholesterol using a genetic blood test - Scotsman

Cholesterol machine pulls out LDL (USA)

"Every two weeks, Kay Dillie is drained of all her blood, one pint at a time. She gets it back, of course, but with less cholesterol. During a recent appointment at Regional Medical Center, Dillie reclined in a chair as tubing pulled her blood from her arm into a machine called the Liposorber. The machine, new to the center, removed her blood, strained out the bad cholesterol known as LDL and returned the blood to her body. Near the bottom of the Liposorber, the liquid LDL from Dillie’s blood began to pool in a bag. When first removed, it looks like melted butter, but will turn to a Silly Putty consistency if exposed to the air." - Rapid City Journal

Clinical trial to explore link between vitamin D and cholesterol

"An unusual finding in previous studies of vitamin D-deficient patients has prompted Rockefeller University researchers to launch a new clinical study to determine whether there is a causative link between vitamin D supplementation and changes in cholesterol levels in people at risk for cardiovascular disease. Led by Manish Ponda, instructor in clinical investigation in Jan L. Breslow's Laboratory of Biochemical Genetics and Metabolism, the clinical trial is currently recruiting subjects" - PhysOrg.com

The medical secret behind Mona Lisa's smile?

"For centuries, art historians have been troubled by Mona Lisa's enigmatic smile - but, according to one doctor, her cholesterol levels were more worrying. For Dr Vito Franco, from Palermo University, she shows clear signs of a build-up of fatty acids under the skin, caused by too much cholesterol. He also suggests there seems to be a lipoma, or benign fatty-tissue tumour, in her right eye. The professor of pathological anatomy at Palermo University presented his finding at a medical conference in Florence" - BBC

'No fasting' for cholesterol test (UK)

"Patients may not need to fast before having their cholesterol tested, a major report has found. After analysing data from 300,000 people, Cambridge researchers found results were just as accurate if the patient had eaten before the test. For decades patients have been told to fast for 12 hours prior to a test. It is hoped the study, published in the Journal of the American Medical Association, may inform new guidelines for doctors in the UK. Cholesterol tests have long been a key part of assessing a patient's risk of cardiovascular problems, and those who turned up having eaten breakfast were required to make a fresh appointment. It had been thought that the body needed enough time to digest food in the system and to clear any fatty particles from the blood in order to produce an accurate reading of so-called "bad" cholesterol - or low-density lipoprotein (LDL). But data from 68 long-term surveys in 21 countries suggests this is not the case - BBC