"The more information we get, the wider the net becomes," says Antonio Gotto, M.D., dean of Weill Cornell medical college in New York City and a leading statin researcher. So even patients with low cholesterol could benefit. A British study published last year showed that patients who lowered their LDL cholesterol by 40 points reduced their risk of myocardial infarction and other coronary "events" by 25 percent-regardless of their original LDL level. The ensuing "statin bonanza," as one medical-marketing publication described it, has been fed by a steady stream of research showing the benefits of various statin drugs, first in patients with high cholesterol and established heart disease, and later in progressively lower-risk populations. In clinical trials, this has translated into a 20 to 60 percent reduction in LDL cholesterol. All told, Americans swallowed $12.5 billion worth of statins last year, more than antidepressants such as Paxil and Prozac and allergy medicines such as Allegra and Claritin.ĭeveloped in Japan in the 1970s, statins work by inhibiting an enzyme that helps to synthesize cholesterol in the liver. The top seller was another statin, Pfizer's Lipitor, with more than $6 billion in sales. Last year, patients (or their insurance companies) spent $4.2 billion on Zocor, making it the second-biggest-selling prescription drug in America. The upside? At least they'll all have low cholesterol. In both cases, the result is the same: a huge number of men who are now, or soon will be, overweight, out of shape, and at risk of debilitating side effects, not to mention diabetes and metabolic disorders. Other men practically have the decision made for them, by doctors who have more faith in the power of statins than in the willpower of their patients. They would rather pop a pill, one with potentially serious side effects, than exercise, eat better, and make other lifestyle changes that could lower their cholesterol and improve their overall health. Except that as many as half of these men shouldn't be taking them at all. Millions of men have enjoyed the benefits of statins.
Here's what Bailey's doctor knew: Zocor and other HMG-CoA-reductase inhibitors-statins-have proved tremendously effective at cutting cholesterol levels, especially levels of deadly low-density lipoprotein, or LDL, cholesterol, which has been firmly linked to heart disease. Finally, he got his wish, and a prescription. For a year, he begged his doctor to just give him the "magic-bullet pill," as he calls it.
Instead, he requested the little, pink, shield-shaped tablet that he knew would solve everything-Zocor. His doctor continued to push dietary changes and exercise, but Bailey wouldn't budge.
"I told my doctor, 'I'm older, fatter, and lazier, and that's not about to change,'" he recalls, now weighing in at 230. In fact, he predicted his cholesterol would keep climbing. So when Bailey saw the writing on his artery wall and it read "299," he wasn't all that surprised. He became heavier and slower and hungrier, thanks in part to his wife's cooking and his high-stress job as a mental-health counselor at a VA hospital in Little Rock, Arkansas. But tendinitis put an end to the running, and he grew sedentary. He ran three or four times a week, as much as 7 miles a day. There was a time, 20 years ago, when Bailey carried 180 pounds on his 5'11'' frame.
So why isn't Bailey's doctor celebrating? "This is the first time I can remember having 'normal' lipid profiles." "To say I'm elated would be an understatement," he says. Today, thanks to the cholesterol-lowering drug Zocor, Bailey's score has plummeted to 153, nearly a 50 percent drop. One year ago, the 48-year-old father of two shocked his doctor with a total-cholesterol score of 299.
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