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Is it possible to have reversal of blockages by taking medication?


There are many studies which have shown recently that a blocked artery can actually improve if a statin drug is used to lower cholesterol. In a study published recently it has shown that in a group of about 500 patients when given a large dose of a statin drug, the lesions actually improved. There was only modest improvement in the narrowing but definite improvement was noted over a long period of time.

In this particular study the drug Crestor was given at 40 mg. This is a large dose of Crestor and it is about the most potent of the statin drugs that we have. Crestor at this level resulted in LDL or bad cholesterol level of 60.8 in this study. This is a very low level, given the fact that the average LDL is in the range of 120. LDL is the ‘bad cholesterol’ in our blood and we have recently felt that getting the level well below 100 ie in the range of 70 might indeed result in improvement in these blockages. This study did demonstrate that Crestor at these levels is an extremely effective agent and lowers the LDL cholesterol beyond levels we thought possible only a few years ago.

There was a statistically significant improvement in these individuals with very low LDL levels, but of course this was a small study and indeed a study that will only launch future efforts in this area. My personal feeling is that with a combination of risk factor reduction, ie smoking cessation, weight loss, exercise, a low fat diet, achieving a normal body weight, managing stress and blood pressure as well as possible, is necessary in this equation. The ability that we now have to make such a large impact on the bad cholesterol is truly a major achievement in medicine and I believe is the cornerstone for lessening the amount of plaque buildup in the walls of arteries and now possibly reversing this plaque formation.

There are other drugs including a combination drug known as Vytorin, older drugs such as Lipitor and Mevacor and Zocor which may approximate these changes in LDL cholesterol. Certainly the drug Vytorin seems capable of getting the LDL to this level or perhaps even lower. Niacin and fish oil may also help.

Much research needs to done in this area, but for the moment it does seem that reversal of lesions with very aggressive cholesterol management is possible albeit, this process is slow and appears not to make a dramatic reversal. For the moment, treating patients who have extremely narrow vessels and are symp tomatic with medicated stents, bypass surgery and other standard procedures is still quite reasonable. There are now better non-invasive imaging techniques which will enable scientists to study the progression or regression of plaques.


 

 
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