Ask the DOC

By Peter Galvin, MD

It is now generally recognized that the administration of statins (Lipitor, Crestor, etc.) is the cornerstone of contemporary therapy to reduce the risk of major cardiovascular disease (CVD) events (i.e., heart attack, stroke, etc.) in patients for whom primary or secondary prevention is indicated. Primary prevention prevents the onset of CVD in those at risk of developing it (like diabetics and people with hypertension) while secondary prevention prevents worsening of CVD in those who already have it. Research has shown that statins not only lower total cholesterol and LDL (“bad cholesterol”) but also reduce CVD risk due to their anti-inflammatory effects. But there is a sizeable number of patients, estimated between 15% and 30%, who cannot tolerate statins due to their side effects, especially myalgias (muscle aches). Incidentally, research has also shown that many individuals who report myalgia may be suffering from the nocebo effect, also known as the power of suggestion. For example, a patient who is given statins knows that myalgia is a common side effect and therefore expects to get it. Sudden withdrawal from statin therapy can potentially be dangerous because of the increased risk of adverse cardiovascular events. Thankfully, there are alternatives to statins for those who cannot take them.

The first alternative is ezetimibe (brand name Zetia). This works in the gut to bind cholesterol that was consumed and eliminate it. It is not absorbed into the body, so it has minimal side effects (mostly diarrhea) but also does not have any anti-inflammatory properties. Research has shown that ezetimibe may lower total cholesterol but does not affect CVD risk. Also, because it is not absorbed, ezetimibe is not very effective at lowering LDL because, in most people with high cholesterol and LDL, the high levels come from their body making too much cholesterol, not from ingesting it. It is usually prescribed with a statin and rarely by itself. Another alternative to statins is bempedoic acid (brand names Nexlizet and Nizlizol). Unlike ezetimibe, bempedoic acid is absorbed into the body and works in the liver to block cholesterol production. Bempedoic acid was originally intended to treat those with familial, or genetic, hypercholesteremia. After several studies showed that bempe- doic acid reduced LDL levels by 17% to 28%, in 2020 the FDA approved it for this use.

Recently, the results of the CLEAR (Cholesterol Lowering by Bempedoic Acid [ECT1002], an ACL-inhibiting Regimen) Outcomes trial were published. In this large study, bempedoic acid was given to volunteers who were unable to tolerate statins. The study found that bempedoic acid reduced the incidence of adverse cardiovascular events by 13% as compared to the placebo group. It also found that levels of high-sensitivity CRP (C-reactive protein), a marker for inflammation, were significantly reduced as compared to placebo. And the side effect profile for bempedoic acid was similar to placebo, meaning that it did not cause the achiness often seen with statins. So, it seems that medical science may finally have found a safe and effective alternative for statins for those unable to take them. Of course, because bempedoic acid is so new, more studies are needed. But the future looks bright for those statin-intolerant individuals at risk for CVD.

Please direct questions and comments to editor@rockawaytimes.com

Saturday, June 24, 2023 Saturday, June 24, 2023 11AM-4PM 11AM-4PM

In celebration of Men's Health Month, join us for a day about Men's Health & Wellness, with activities and education for the whole family.

Complete your "Passport to Wellness" booklet to receive a free swag bag!*

Speaking

"Beyond the Stigma" - Barber Shop Mental Health Program

- by Assemblyman Khaleel M. Anderson

Men's Mental Health

Physical Health & Stress Management for Men

Other Activities Including:

Wellness & Community Vendor Fair

Healthy Food Tastings

Free Health Screenings

Family Activities including Face Painting, Bouncy Castle & Games

Entertainment including DJ and Comedian

*While supplies last

Scan the QR code Scan the QR code to register to register

By Kami-Leigh Agard

With Rockaway in summertime mode, make The RT’s Good Times page your ultimate guide to live music, films, theater and more! See this week’s roundup below:

THURSDAY, June 15 5 p.m.

Get an early kickoff to the weekend at Rockaway’s bayside treasure, The Wharf with Searing, Brady and Butler!

416 Beach 116th Street

THURSDAY, June 15 7 p.m. to 10 p.m.

It’s almost Friday! So, why be moody when you can shake your booty, belting out songs with live karaoke band, Dan and Rich, at Tap That!

111-04 Rockaway Beach Blvd.

FRIDAY, June 16 6 p.m. to 10 p.m.

Be baptized under the stars with Uncle Jack’s classic rock brews at Tap That and become an official member of the Jack Pack!

111-04 Rockaway Beach Blvd.

FRIDAY, June 16 6:30 p.m.

Come to the Belle Harbor Yacht Club and see why country music queen Lauren Jaimes has earned her crown in venues all over Rockaway.

533 Beach 126th Street

FRIDAY, June 16 8 p.m.

Who rules the bay tonight at The Wharf? None other than Breezy queens, The Pointers!

416 Beach 116th Street

FRIDAY, June 16 8:30 p.m. to 11 p.m.

Kerry Kearney & Friends turn up the heat with their sizzling blend of roots and blues at Bar Marseille.

190 Beach 69th Street

FRIDAY, June 16

9 p.m. to 1 a.m.

As stated by “Farce The Music,” “If you've got a fetish for plenty of spilled shots of Jameson’s, Murphy’s Lawyer will ring your bell.” Don’t miss him at Rogers!

203 Beach 116th Street

THURSDAY, JUNE 15, 2023