Rethinking Cholesterol
Drug Developments and Lifestyle Choices

Summary

We are deeply saddened by the loss of Dr. Lawrence H. Cohn, advisor and supporter of this Forum in addition to others in the The Dr. Lawrence H. and Roberta Cohn Forums series.

For decades, statins have served as the “go-to” drug for patients with high cholesterol. Now, a new class of cholesterol-reducing drugs, PCSK9 inhibitors, just approved by the FDA, offers a possible alternative to statins. Adding to the changing landscape of cholesterol treatment are recommendations from the American Heart Association and American College of Cardiology, issued in 2013, that dramatically expanded the number of people who could potentially receive statins to prevent heart attack or stroke. Together, these developments have renewed focus on cholesterol as a major health issue. What role might this new class of cholesterol-lowering drugs play? How might their cost impact access and insurance coverage? What lifestyle factors, especially dietary fats, influence the prevention and treatment of cholesterol-related risk factors?

Brief Video Highlight

Part of: .

Presented in Collaboration with Reuters and in Association with Harvard Health Publications

Background Articles

Image Credit: iStockphoto.com l janulla

  • salbers

    What effect does serum Omega 3s and the Omega 6/3 ratio have on influencing effects of cholesterol and cardiovascular health?

  • salbers

    Since the government-approved Ornish Plan for reducing cholesterol has an 82% success rate with no risk of side effects or cost, when can the use of drugs be justified?

  • The Forum Moderator

    Welcome everyone. We’re glad you can join us. Our live webcast will begin at 12:30pm ET.

  • The Forum Moderator

    We’ll begin in just a few minutes.

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    We’re about to begin.

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    Thank you for joining us today. Our event has begun.

  • The Forum Moderator

    The stream should begin on its own, but you can also simply press play.

  • The Forum Moderator

    We’re starting the live stream. Stick with us if you are getting a standby message.

  • The Forum Moderator

    This event is in collaboration with Reuters and in association with Harvard Health Publications.

  • The Forum Moderator

    Harvard Medical School has a special report called Managing Your Cholesterol in which you might be interested. You can read it here: http://www.health.harvard.edu/heart-health/managing-your-cholesterol

  • The Forum Moderator

    This clip is courtesy of CardioSmart about a young man who had a heart attack.

  • Amy Babcock

    Will the PCSK9 inhibitors be effective in the treatment of Familial Hypercholesterolemia?

    • The Forum Moderator

      Thanks for the question. We will be addressing FH patients more specifically later in our discussion.

      • Amy Babcock

        Great – thank you!

  • The Forum Moderator

    Dr. Manson recently wrote a piece on the Harvard Health Publications site called The Type of Fat You Eat Matters, where she wrote: “It’s not just the amount of saturated fat you eat, it’s also what you
    replace those calories with (the quality of your overall diet) that
    affects your health.” http://www.health.harvard.edu/blog/the-type-of-fat-you-eat-matters-201509228333

  • PL

    Why isn’t a licensed Registered Dietician not invited on this panel to discuss about lifestyle or behavior changes?

    • The Forum Moderator

      Thanks PL. We at the Harvard Chan School are very interested in lifestyle or behavior changes and our panelists will address those.

  • PL

    Right on! I am so elated to hear what Dr. Sacks has to say about low fat diet and his description of the patient’s lunch is spot on.

    • The Forum Moderator

      Thanks! That was actually Dr. Sacks speaking; He has been involved in the DASH diet studies to reduce sodium, among other studies.

      • PL

        Can you ask Dr. Sacks, if he knows of any studies on the DASH diet and correlation of amyloid beta concentration in blood plasma, since he mentioned about cognitive decline?

  • The Forum Moderator

    This clip was provided courtesy of Stanford. Patients with FH are thought to be among those who may benefit from the new PCSK9 inhibitors.

  • The Forum Moderator

    Do you have a question for the panelists? Post them here.

  • PL

    Can Dr. Manson please explain how statin can increase development of diabetes? Does statin decrease insulin regulation? Or are the target populations think that by taking statin, they feel freely to eat whatever foods they like?

  • PL

    I agree with Dr. Manson – start with exercise first before prescribing statin. Well stated!

  • The Forum Moderator

    Our event will end in about 10 minutes. We will post the full-length video on this site tomorrow or Monday. We’ll also post it and clips on YouTube and iTunesU.

  • Laura Bruzas

    Question? Benecol and Promise’s Take Control are often recommended for their plant sterols yet contain some really not-so-good ingredients. Can you recommend some other options to include in a daily diet?

    • The Forum Moderator

      Thanks Laura!

  • Amy Babcock

    Education is key and it has to begin in early childhood. I hope the American Academy of Pediatrics can successfully lobby for better children’s environmental health. Much of the research focuses on adults; we need to recognize that disease patterns are set up much earlier in development.

    • The Forum Moderator

      Thanks Amy, Great observation.

  • Dr. Pamela D. Straker

    Have there been studies surrounding different ethnic populations and the impact of the drugs on them?

  • Donna Klein Dworak

    I was able to take Crestor for three years and then developed severe muscle spasms in my legs, feet, ankles. I tried every other statin out there and tried low dose, alternate days. I then tried Zetia and after several months found the same muscle spasm problem. I seem to be able to take Zetia for two weeks and then off for two weeks. Will that help? I am 70, exercise daily, no diabetes and don’t smoke.

  • Nellie Wixom

    What is your take on coconut oil? Is it neutral, cardio protective or detrimental?

  • The Forum Moderator

    Great questions! We’re trying to get to as many as we can before our event ends.

  • Sek Won Kong

    How often do we need to measure cholesterols while on statins and the others? I am asking this since insurance companies do not cover all lab tests.

  • The Forum Moderator

    We are wrapping up our discussion. If we weren’t able to get to your question, we apologize and encourage our viewers to continue the conversation on this site by posting comments and responding to each other.

  • Amanda

    I’m a Registered Dietitian and I loved what Dr. Sacks was saying about dietary confusion with heart disease/cholesterol. It is amazing how many patients I see who get a “low fat” diet order from their physician. It is so important for physicians to know that dietitians can and will help patients understand an appropriate diet for their disease states and now insurance covers Medical Nutrition Therapy for hypercholesterolemia/heart disease.

    • Psych MD

      Rather than tailoring diet to a specific “disease state,” I agree with Dr. Michael Greger, founder of nutritionfacts.org, that a whole food, plant-based diet is the “best” diet for everyone. Plants, with particular emphasis on leafy greens, brassicas, nuts, seeds, berries, legumes, spices, etc. offer health promoting, disease fighting constituents. Eating in this fashion essentially eliminates diet from the equation. It’s like building a sportscar. Start with 500 horsepower and you don’t need to worry about performance.

  • The Forum Moderator

    Join us again for our October 1 discussion on Revisiting Race, Criminal Justice and Health and for our October 6 discussion on the European Refugee and Migrant Crisis. Both at 12:30pmET on The Forum site and in collaboration with PRI’s The World & WGBH.

  • The Forum Moderator

    Thank you again for joining us today! Just a quick reminder that we will post the full length video on this site tomorrow or Monday and on YouTube and iTunesU.

  • PL

    Policy making – we need more community nutritionists!

  • The Forum Moderator

    We thank Reuters and Harvard Health Publications.

  • The Forum Moderator

    Thank you all again!

  • Laura Bruzas

    Wonderful webinar! I will spread the word about it and share the video link with my newsletter readers.

    • The Forum Moderator

      Much appreciated!

  • Paul Nisson

    is the entire session available after the fact?

    • The Forum Moderator

      Hi, Yes, the entire webcast will be posted.

  • salbers

    The Lyon Heart Study offers considerable evidence that the Omega 6/3 ratio has value. What evidence supports the claim that the ratio has no value?