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Prescription of Statins to Women Poses New Clinical Challenges

In women and men, cardiovascular disease is and will remain the leading avoidable cause of premature death in the United States and is rapidly becoming so worldwide.1 Although many women fear breast cancer more than cardiovascular disease, 1 in 8 will develop and 1 in 25 will die of this disease, whereas more than 1 in […]

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Sudden Creatine Kinase Elevation When an Athlete Starts Boxing: Looking Deeper Prior to Knocking the Statin Out

A 55-year-old Caucasian man with a prior computed tomography calcium score in the 75th percentile for age, sex, and race at age 39 years, and on long-term high-intensity statin therapy presented with episodic myalgia. He reported 3 episodes within the past year of sudden severe quadriceps pain that self-resolved within 2 days. His activities included biking […]

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Joseph S. Alpert

Statins and Diabetes: Wider Utilization Is Needed in Treatment and Prevention

  In this issue of The American Journal of Medicine, Hennekens et al1 address many cogent methodologic issues concerning whether there is a valid statistical association between statins and the development of diabetes. While they conclude that the current totality of evidence is insufficient to confirm a valid association, if such an association were present, the most plausible […]

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Reduction in Percent LDL Cholesterol or Attained LDL-C Levels or Both?

The role of low-density lipoprotein cholesterol (LDL-C) in the pathophysiology of atherosclerotic cardiovascular disease, which may present as coronary heart disease, stroke, and peripheral arterial disease, has been well documented in several studies. The decrease in LDL-C levels leads to a significant reduction in the risk of atherosclerotic cardiovascular disease. Statins have become the first line […]

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Grapefruit Juice and Statins

Should patients avoid grapefruit juice consumption while taking widely used statins? A daily glass of grapefruit juice increases blood levels of simvastatin and lovastatin by about 260% if taken at the same time (about 90% if taken 12 hours apart), and atorvastatin by about 80% (whenever taken). Simvastatin 40 mg, lovastatin 40 mg, and atorvastatin […]

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Joseph S. Alpert, MD

New Research: Stroke Rates Fall by 40% (video)

Incident strokes in the Medicare population fell by nearly 40% over the last 2 decades, a greater-than-expected decline. Check out Trends in Stroke Rates, Risk, and Outcomes in the United States, 1988 to 2008 the July 2014 issue of The American Journal of Medicine to learn more.

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