Stroke, heart attack victims getting younger

MANILA, Philippines - Time was when only middle-aged and older patients were known to be suffering from complications of atherosclerosis, or the narrowing of arteries in the body.

Recent statistics show that now, much younger individuals — barely in their 20s and early 30s — can fall victim to serious atherosclerotic complications such as heart attack and stroke.

Health experts resonated this alarm during the recently concluded 14th Joint Annual Convention of Philippine Society of Hypertension (PSH) and Philippine Lipid and Atherosclerosis Society (PLAS).

Dr. Om Ganda, senior physician and director of the Lipid Clinic at Joslin Diabetes Center in the United States, echoed this alarming situation in his lecture during the convention and discussed effective therapeutic interventions to reduce the risk of patients from developing serious disabling complications.

An associate professor of medicine at Harvard Medical School, Ganda has been engaged in clinical diabetes research for more than three decades, making him an internationally renowned authority on the subject of atherosclerosis and its risk factors particularly diabetes.

“Changing their lifestyle, especially those with family history of heart disease, is still the best way to prevent it,” he said.

But for those with established cardiovascular disease already and those who are at risk, drug therapy especially with the use of statins — a popularly prescribed cholesterol-lowering drug — can significantly reduce the risk of these patients from developing heart attack, stroke, and other complications of atherosclerotic cardiovascular disease.

Ganda discussed the clinical importance of findings from the JUPITER (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin) study, which showed that the treatment of apparently healthy patients with a statin cuts their risk of cardiovascular disease and related death by almost half.

Individuals enrolled in the study had normal or even low “bad” or low-density lipoprotein (LDL) cholesterol but an elevated C-reactive-protein (CRP) levels, a laboratory blood test to identify patients at high-risk for a cardiovascular complications.

Those receiving rosuvastatin 20 mg significantly reduced the risk of non-fatal heart attack, stroke, hospitalization for chest pains, need for angioplasty or bypass surgery, and confirmed death from cardiovascular causes — by 44 percent compared with individuals treated with placebo or dummy pill.

Prematurely stopped after 1.9 years due to the obvious benefit of those in the statin group, experts worldwide have acknowledged the JUPITER trial as one of the most important clinical trials in primary prevention of cardiovascular disease.

Ganda, who has been co-investigator in various notable international clinical trials such as the landmark Diabetes Control and Complications Trial (DCCT) and the Diabetes Prevention Program (DPP), explained the benefits of promptly initiating statin therapy for high-risk patients and even apparently healthy individuals with elevated hs-CRP levels.

His fellow local experts who attended his lecture agreed that discarding the unhealthy lifestyle which modern times bring, plus early intervention with effective therapies such as statins, can stem the tide of cardiovascular disease in our country.

Two local luminaries in the cardiovascular field — Dr. Ramon Abarquez Jr., emeritus professor at the University of the Philippines College of Medicine; and Dr. Romeo Divinagracia, professor at the University of the East Ramon Magsaysay College of Medicine — gave similar insights during the open forum.

Rosuvastatin is a prescription product and one should consult his or her physician to determine if one is suitable to take it to reduce cholesterol or lower cardiovascular risk.