Latest news with #JournalofNeurology
CNBC
03-05-2025
- Health
- CNBC
Brain health experts' top 3 tips for lowering your risk of dementia, stroke and depression—all at the same time
There are certain lifestyle choices that can lower your risk of developing dementia, stroke and depression later in life, according to a recent study published in the Journal of Neurology, Neurosurgery & Psychiatry. "At least 60% of stroke, 40% of dementia and 35% of late-life depression are attributable to modifiable risk factors," the study found. It turns out that people who've had a stroke before tend to develop depression or dementia, and the same is true in the reverse, Dr. Sanjula Singh, the lead author of the study, told The New York Times. Singh is also a principal investigator at the Brain Care Labs at Massachusetts General Hospital. Here are the top three practices that experts found have the greatest effect on your chances of staving off these brain conditions. If you don't know where to start, you can take a quiz to get your Brain Care Score, which is a system created at Mass General to measure how healthy your brain is. To receive your score, you answer questions about your lifestyle choices like your blood pressure levels, dietary habits and sleep quality. Having a higher Brain Care Score is associated with having a lower risk of dementia, depression and stroke, according to a study published in Frontiers in Psychiatry. And even lower scores can get a boost by working on the areas of improvement that are suggested in your results, according to Dr. Jonathan Rosand, a professor of neurology at Harvard University who treats patients with head trauma, spinal cord injuries and strokes at Mass General. "The key is to take the score as a guide and just use it for yourself to improve it, however you want to start improving it," Rosand told CNBC Make It in December of 2024. It's important to consult with a physician if you notice any early signs or symptoms of depression, stroke or dementia. "It's really helpful when you go to the doctor if you bring the score with you and you've already decided, 'This is what I'd like to work on.'" And make sure to consult your own medical professional regarding your specific health needs.
Telegraph
08-04-2025
- Health
- Telegraph
Should I be taking statins for my cholesterol? An expert guide
If you were offered a potentially life-saving drug, free on the NHS, is there any doubt you would refuse it? Experts have been increasingly realising that statins could be the magic bullets to help halt the alarming rise in heart deaths – and new research has shown that they could also play a part in reducing dementia risk. The research, published in the Journal of Neurology, Neurosurgery and Psychiatry, found that people taking the cholesterol-busting drug were less likely to develop dementia, including Alzheimer's disease. The risk of dementia reduced further among people who already had low cholesterol and were taking the statins compared to those who were not, suggesting the drugs provide 'additional protective effects'. In 2023, the National Institute for Health and Care Excellence (Nice) watchdog which provides guidelines for the NHS, released a set of new recommendations suggesting that statins should be rolled out on a far wider scale for those at risk of cardiovascular disease. Around 10 million people in England are currently eligible for the cholesterol-lowering drugs but Nice recommended widening the window of eligibility to encompass those between 25 and 84 who are deemed to have a 10 per cent or higher risk of a cardiovascular event in the next decade. The new research on dementia risk also raises the prospect of younger people with normal levels of cholesterol being given statins to protect the health of both their heart and brain. Sir Nilesh Samani, medical director of the British Heart Foundation and a cardiology professor, says it is without question that statins are life-saving drugs for patients with existing heart disease. 'If you had a heart attack or a stroke, or you suffer with coronary heart disease or angina, then the evidence basis is not controversial at all,' he says. 'Everyone would recommend those patients to take them. In terms of people who haven't got an established disease, the statin recommendation is based on an assessment of their risk over the next 10 years.' So what are statins, and how exactly do they work? How do statins really work? Statins are a class of drugs that include atorvastatin, fluvastatin, pravastatin, rosuvastatin and simvastatin. In general, they act to lower the levels of a type of cholesterol known as low-density lipoprotein or LDL cholesterol. Dr Unnati Desai, national lead for GP services at Nuffield Health, says: 'LDL is often referred to as bad cholesterol because elevated levels of LDL are associated with an increased risk of cardiovascular disease.' Statins reduce LDL cholesterol through two main mechanisms of action. The first is to block the activity of an enzyme called HMG-CoA reductase, which plays an essential role in how cholesterol is produced in the liver. They also increase the number of LDL receptors on the surface of liver cells, enabling the liver to remove LDL cholesterol from the bloodstream more efficiently. What are the different types? But while they might work in similar ways, no two statins are the same. They each have distinct chemical structures and vary in potency, dosage and how they are metabolised in the body. High potency statins tend to be offered to patients who have already experienced a serious event such as a stroke or heart attack. 'Some are more effective at lowering cholesterol levels than others,' says Dr Desai. 'For example, rosuvastatin and atorvastatin are considered high-potency statins and can lower cholesterol more effectively at lower doses compared with moderate-potency statins like simvastatin and lovastatin.' Statins can be classified as being either fat-soluble or water-soluble which affects how well they are absorbed within the body and their side effect profile. 'Fat-soluble statins like atorvastatin and simvastatin, are better absorbed and may have a more substantial effect on cholesterol,' says Dr Desai. 'Water-soluble statins, like pravastatin, are less likely to penetrate cells but may be associated with fewer muscle-related side effects.' But we are still learning more about the other benefits statins can bring to cardiovascular health. For example, earlier this year, a study from Stanford Medicine discovered that simvastatin can improve blood vessel health, which could be why heart failure patients who take statins are less likely to suffer a second heart attack. Who could preventative statins be most helpful for? One group of patients who could particularly stand to benefit from preventative statins is the estimated 250,000 people in the UK who have a condition known as familial hypercholesterolemia, which means they have high cholesterol from birth. A 2019 study that followed 214 patients with the condition for 20 years, after they began receiving statin therapy as children, found that it reduced their cholesterol by an average of 32 per cent and reduced their risk of cardiovascular disease in adulthood. However, not everyone is able to tolerate the drugs and scientists are still learning more about some rare statin-induced side effects. In 2023, the UK's Medicines and Healthcare products Regulatory Agency (MHRA) revealed that between 1995 and 2023, there were 10 cases of a neuromuscular disorder known as myasthenia gravis, which may have been triggered by statins. But Samani points out that given the many millions of people who take statins – 9.5 million people were prescribed them in 2022 – it is hard to draw conclusive links between the drugs and such rare isolated events. 'With very rare things, it's very difficult to attribute them to the drug because so many people are on statins,' he says. Should I be taking statins for my cholesterol? Based on the Nice recommendations, NHS doctors will compute a cardiovascular disease risk score for all patients, before offering them the choice of going on statin therapy. The latest tools used to compute these risk scores are based on AI analysis of the patient's electronic health records and consider a whole variety of factors, not just cholesterol levels. 'Factors considered also include age, family history of heart disease, smoking status, blood pressure level, and whether they have diabetes or not,' says Dr Gosia Wamil, a cardiologist at Mayo Clinic Healthcare in London. 'These newer calculators can improve prediction of who needs to be treated or not.' How long do statins take to work? Statins will start to reduce LDL cholesterol within weeks, but it can take several months before their full benefits are apparent. According to Dr Wamil, long-term data indicate that the efficacy of statins remains largely stable over time. 'There have been no indications of waning effectiveness observed even after prolonged use over many years, provided that they are consistently and appropriately administered,' she says. 'LDL should be monitored, and the statin dose may need to be adjusted occasionally to achieve a good effect.' Are statins causing my aches and pains? The most widely cited complaint from taking statins is muscle aches, and having prescribed the drugs for more than 30 years, Sir Nilesh says there is no question that statins are linked to a slightly increased risk of aches and pains. However, he believes that the degree of media coverage surrounding statin-induced muscle aches has contributed to a medical phenomenon known as the nocebo effect (the opposite of the placebo effect), where the belief that a drug will cause harm ends up triggering negative symptoms. In one British Heart Foundation study, participants were given a dummy pill or a placebo, which they believed was a statin, and yet they still complained of muscle aches. Last year, a large analysis published in The Lancet estimated that 90 per cent of the time, muscle aches were not related to statins. 'There's evidence that people have now been conditioned in some way to expect muscle aches with statins,' says Samani. 'So anytime they get aches, they think it's the medicine.' Are there any other side effects? In some very rare cases, statins can cause a condition called rhabdomyolysis in which muscle cells break down, releasing a protein called myoglobin into the bloodstream which can clog up the kidneys, resulting in acute kidney failure and other complications. The early signs of rhabdomyolysis tend to be muscle inflammation, and so people experiencing particularly severe muscle pain after starting on a course of statins should consult their doctor. However, rhabdomyolysis affects only 1.5 in every 100,000 people who take statins. 'Long-term statin use is considered safe and associated with significant benefits in reducing cardiovascular events,' says Dr Wamil. 'Regular monitoring and reporting of any unusual symptoms to a healthcare provider are essential but the benefits of long-term statin use in preventing heart attacks, strokes, and mortality often outweighs potential risks, especially for individuals at high risk of cardiovascular disease.' How much alcohol can I drink with statins? There are no guidelines against drinking alcohol while taking statins, but Dr Desai suggests discussing your typical weekly alcohol consumption with a health professional before starting on the drugs. 'There's no absolute contraindication to drinking alcohol when taking a statin, however it is important to drink within the recommended limit of 14 units per week, ensuring alcohol-free days by spreading the drinks over three or more days during the week,' she says. However, you do have to be slightly careful about grapefruit juice or eating these fruits. This may seem unusual but grapefruit can actually react with certain statins, inducing severe muscle or joint pain. You should avoid them completely if taking simvastatin, while consumption should be minimised when on atorvastatin. Other statins are not known to react with grapefruit. Is there an alternative to statins? For those concerned about whether they will be able to tolerate statins, there is a far wider range of cholesterol-lowering alternatives than ever before. The most widely used alternatives are PCSK9 inhibitors, a class of drugs which includes medications like inclisiran, alirocumab and evolocumab, and have been shown to be capable of reducing LDL cholesterol by around 50 to 60 per cent or more. PCSK9 inhibitors reduce the activity of a protein called PCSK9 that normally blocks the liver's cholesterol receptors. By inhibiting this protein, the receptors are able to keep extracting cholesterol from the blood. 'These drugs are usually used as an additive treatment for people whose cholesterol doesn't come down sufficiently with statins or are statin-intolerant,' says Sir Nilesh. Dr Wamil says that while they tend to be well-tolerated by patients, the disadvantages are that not everyone likes having to receive regular injections and they come at a higher cost for healthcare providers. 'Whether they are better than statins depends on an individual's specific health circumstances,' she says. Should I take statins? Ultimately the question of whether someone should begin taking statins, depends very much on their individual health circumstances. 'For anyone, their risk is a third lower with a statin,' says Dr Iqbal Malik, a consultant cardiologist and medical director of One Welbeck Heart Health in London. 'If your risk is near zero, it is not worth it, but if your risk is very high, it is definitely worth it.' Sir Nilesh Samani says that statin therapy should always be the result of a shared decision-making process between the cardiologist and the patient, and a two-way conversation about their risk of disease and the relative benefits which the drug might be able to offer them. 'There's always the balance between trying to reduce the total number of heart attacks and strokes, and the issue of medicalising more of the population,' he says. 'So it is very much an individual, shared decision-making process. If the patient is a frail 85 year old with multiple other health problems, then a statin might not be the right thing. But if they have a family history of disease, and a 10 per cent risk of having a stroke in the next decade, most doctors would feel that the benefits are probably there.'
Yahoo
02-04-2025
- Health
- Yahoo
Four potential side-effects of cholesterol-lowering drugs statins
In the early Noughties, "cholesterol" became a bit of a buzzword, with campaigns and advertisements telling us we should care about it – and seek to maintain healthy levels. And although its prominence in conversation has died down somewhat in recent years, its importance is no less real, with 59% of people in the UK experiencing raised cholesterol in 2021. High levels of cholesterol was most evident in those aged 45 and 64 (72%) and among adults aged 16 to 33, men (53%) were more likely than women (46%) to have raised levels. Now, a new study has also linked reduced levels of bad cholesterol with curbing the risk of dementia, finding that people with low-density lipoprotein (LDL-C) in their blood are 26% less likely to develop dementia and Alzheimer's disease. It also looked at the use of statins – cholesterol-lowering medications – and found them to provide an "additional protective effect" against the condition. Here, we take a look at what statins are, how they work – and the potential side-effects and benefits of the drug. A group of medicines that help lower the level of LDL cholesterol – "bad cholesterol" – in the blood, statins are designed to reduce the production of it inside the liver. The drugs are normally prescribed to those with potentially dangerous levels of LDL-C, which, in turn, can lead to the hardening and narrowing of the arteries and result in cardiovascular disease or atherosclerosis. Coming in tablet form, statins are taken once daily, but the dose will depend on your medical needs. This dosage may also change over time, depending on what your GP deems necessary. Most people have to continue taking statins throughout their life once they have been prescribed them. Headaches Dizziness Nausea Digestive problems, such as indigestion, diarrhoea or constipation Muscle pain Problems with sleep Low blood platelet count Feeling tired or physically weak Muscle damage – This usually only happens when statins are taken in combination with other medication Loss of sensation or tingling in the nerve endings Tendon problems Hair loss Memory problems Skins irritation Loss of sex drive Erectile dysfunction Being sick Liver damage In addition to the 2025 study published in the Journal of Neurology, Neurosurgery & Psychiatry (outlined above), a 2016 study published by the same journal also linked statins to a lower risk of dementia and Alzheimer's. Looking at 400,000 Medicare beneficiaries who used the drugs, the research found that men in the group who had taken the medication regularly for two years had a 12% lower risk of developing Alzheimer's. Various studies have also looked at the impact statins have on cancer risks, but the results have been inconsistent and there's no conclusive answer right now. More research needs to be done to gauge whether statins can, indeed, lower the risk of certain cancers. The drugs have also been found to reduce inflammation and irritation, and the exacerbation of atherosclerosis, which is a major cause of coronary artery disease (CAD). Research published by Nature Communications in 2019 discovered a new link between statins and immune systems. It found that by using medications like statins, they could modify cell responses in the lab. Professor Andrew Cope, lead investigator of the study, said: "We think that our findings could explain why people taking statins are better at fighting influenza, and why patients have better outcomes for some types of cancer." Read more about health conditions: Seven health conditions you can visit your pharmacy for (Yahoo Life UK, 4-min read) Seven chronic health conditions you've (probably) never heard of (Yahoo Life UK, 6-min read) Six crucial things to learn about your health - before it's too late (Yahoo Life UK, 7-min read)
Yahoo
02-04-2025
- Health
- Yahoo
Four potential side-effects of cholesterol-lowering drugs statins
In the early Noughties, "cholesterol" became a bit of a buzzword, with campaigns and advertisements telling us we should care about it – and seek to maintain healthy levels. And although its prominence in conversation has died down somewhat in recent years, its importance is no less real, with 59% of people in the UK experiencing raised cholesterol in 2021. High levels of cholesterol was most evident in those aged 45 and 64 (72%) and among adults aged 16 to 33, men (53%) were more likely than women (46%) to have raised levels. Now, a new study has also linked reduced levels of bad cholesterol with curbing the risk of dementia, finding that people with low-density lipoprotein (LDL-C) in their blood are 26% less likely to develop dementia and Alzheimer's disease. It also looked at the use of statins – cholesterol-lowering medications – and found them to provide an "additional protective effect" against the condition. Here, we take a look at what statins are, how they work – and the potential side-effects and benefits of the drug. A group of medicines that help lower the level of LDL cholesterol – "bad cholesterol" – in the blood, statins are designed to reduce the production of it inside the liver. The drugs are normally prescribed to those with potentially dangerous levels of LDL-C, which, in turn, can lead to the hardening and narrowing of the arteries and result in cardiovascular disease or atherosclerosis. Coming in tablet form, statins are taken once daily, but the dose will depend on your medical needs. This dosage may also change over time, depending on what your GP deems necessary. Most people have to continue taking statins throughout their life once they have been prescribed them. Headaches Dizziness Nausea Digestive problems, such as indigestion, diarrhoea or constipation Muscle pain Problems with sleep Low blood platelet count Feeling tired or physically weak Muscle damage – This usually only happens when statins are taken in combination with other medication Loss of sensation or tingling in the nerve endings Tendon problems Hair loss Memory problems Skins irritation Loss of sex drive Erectile dysfunction Being sick Liver damage In addition to the 2025 study published in the Journal of Neurology, Neurosurgery & Psychiatry (outlined above), a 2016 study published by the same journal also linked statins to a lower risk of dementia and Alzheimer's. Looking at 400,000 Medicare beneficiaries who used the drugs, the research found that men in the group who had taken the medication regularly for two years had a 12% lower risk of developing Alzheimer's. Various studies have also looked at the impact statins have on cancer risks, but the results have been inconsistent and there's no conclusive answer right now. More research needs to be done to gauge whether statins can, indeed, lower the risk of certain cancers. The drugs have also been found to reduce inflammation and irritation, and the exacerbation of atherosclerosis, which is a major cause of coronary artery disease (CAD). Research published by Nature Communications in 2019 discovered a new link between statins and immune systems. It found that by using medications like statins, they could modify cell responses in the lab. Professor Andrew Cope, lead investigator of the study, said: "We think that our findings could explain why people taking statins are better at fighting influenza, and why patients have better outcomes for some types of cancer." Read more about health conditions: Seven health conditions you can visit your pharmacy for (Yahoo Life UK, 4-min read) Seven chronic health conditions you've (probably) never heard of (Yahoo Life UK, 6-min read) Six crucial things to learn about your health - before it's too late (Yahoo Life UK, 7-min read)
Telegraph
01-04-2025
- Health
- Telegraph
Statins could reduce dementia risk even if you have low cholesterol
Statins can reduce the risk of dementia among those who already have low cholesterol, a study has suggested. People taking the cholesterol-busting drugs were less likely to develop dementia, including Alzheimer's disease, even if they already had their cholesterol under control, experts found. The research, published in the BMJ's Journal of Neurology, Neurosurgery and Psychiatry, found that people with healthy levels of 'bad' cholesterol in their blood were at reduced risk of the neurological condition compared to those with high levels. But they also found that the risk of dementia reduced further among people who already had low cholesterol and were taking statins compared to those who were not, suggesting the drugs provide 'additional protective effects'. While statins are usually prescribed to people in their 60s or 70s, the findings raise the prospect they could be given to younger people with normal levels of cholesterol as a way of protecting the health of both their heart and brain. The researchers said the drugs were providing a 'synergistic effect' and could have a much bigger role to play in brain and cognitive health than previously thought. Statins are one of the most commonly prescribed drugs in the UK, with around seven to eight million people taking the cheap, daily pills to cut their chance of heart attack and stroke. 'More to Alzheimer's than we first thought' The medicine can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood, often referred to as the 'bad cholesterol' because it can lead to plaque build-up in arteries and increase the chance of strokes, heart attacks and heart disease. Researchers from South Korea, led by Hallym University and Kangdong Sacred Heart Hospital in Seoul, said their findings 'underscore the crucial role of managing LDL- C in lowering dementia risk'. They examined health data on more than 570,000 people aged 18 and older in South Korea. The NHS says that people should aim for bad cholesterol levels in the blood to be below 4mmol/L (millimoles per litre). Researchers found that people with low LDL cholesterol levels below 1.8 mmol/L were 26 per cent less likely to develop dementia and 28 per cent less likely to develop Alzheimer's. This was compared to those with levels above 3.4 mmol/L - the higher end of a healthy range. Taking statins saw those with LDL cholesterol levels below 1.8 mmol/L reduce their dementia risk by a further 13 per cent and 12 per cent for Alzheimer's compared with people who do not take them. 'These findings emphasise the importance of targeted LDL- C management as part of dementia prevention strategies, with potential integration into clinical guidelines,' the authors wrote in the Journal of Neurology Neurosurgery and Psychiatry. 'The results support the use of statin therapy within specific LDL- C ranges for both cardiovascular and cognitive health benefits.' The study found the benefits of statins tailed off among people whose LDL cholesterol levels were 'very low' and had fallen below 0.8 mmol/L, suggesting a threshold with 'optimal benefit' that should be targeted and personalised to individuals. They added: 'This insightful understanding of how statin use interacts with LDL- C levels emphasises the need for personalised statin prescriptions, focusing on achieving LDL- C levels that offer the maximum cognitive benefits.' Dr Francesco Tamagnini, neurophysiologist at the University of Reading, said there was 'clearly more to the story of Alzheimer's than we first thought.' 'The results give a convincing argument for researchers to consider LDL cholesterol in addition to the classic approaches,' he said, hypothesising 'that damage to the blood-brain barrier can lead to accumulation of LDL cholesterol in the brain and potentially alter the electrical activity of neurons.' He said proteins, amyloid and tau, had been widely considered as the 'main cause of Alzheimer's but that is an opinion that is now likely to fade.' He added: 'Alzheimer's disease may be a complication caused by the accumulation of LDL in the brain. What we now need to find out is exactly how the high levels of lipids in the blood are causing Alzheimer's and other types of dementia.' Dr Julia Dudley, head of research at Alzheimer's Research UK, said the results suggested 'the use of statins seemed to offer a protective effect – even in those who already had cholesterol levels within a lower range.' 'However, dementia risk is complex and influenced by many factors. Without a detailed picture of what's going on in the brain we do not know if there is a direct link between lower cholesterol and reduced dementia risk,' she said. She added that trials would be 'key to understand what effects statins might be having on disease processes in the brain.' Almost one million people in the UK are living with dementia – a figure which is expected to rise by about 50 per cent over the next 15 years.
