Q: I just read that taking statins can cause diabetes, which can seriously increase my risk for heart disease. I thought statins were supposed to reduce my risk. What’s the story? â€” Bernardo S., Boca Raton, Florida
A: You’re referring to the six-year follow-up to the “Metabolic Syndrome in Men” study that was recently published in the journal Diabetologia. Researchers found that among study participants who took statins (simvastatin or atorvastatin) insulin sensitivity was decreased by 24 percent and insulin secretion by 12 percent; plus, the risk of developing Type 2 diabetes jumped by 46 percent. The dose of statins affected the degree of increased risk.
Let’s look at that. These guys already had metabolic syndrome. That means they had at least three of the following health issues: a large waistline, high triglycerides, low HDL “good” cholesterol, high blood pressure and high fasting blood sugar â€” all associated with developing diabetes whether you take statins or not. Plus, previous studies have shown that folks on statins tend to think they have a free ride (“The pill will make up for the high-fat, overprocessed foods I eat”) and end up indulging in cheeseburgers or ice cream and throw dietary caution to the wind. In fact, research has found that in the decade since 2000, people taking statins for high cholesterol increased their caloric intake by 9.6 percent and their fat intake by 14.4 percent.
The diet choices statins users make, if they’re fat-laden, could add to increased insulin resistance and decreased insulin production. But we know that statins are an effective way to lower lousy LDL cholesterol and are associated with a decrease in the risk for heart attack and stroke. So, don’t stop taking statins without talking to your doc. And don’t pop statins and eat barbecue pork. Maybe the real bottom line is that taking statins and eating lousy food is more dangerous than we thought.
Q: I’m 44 and was scheduled for foot surgery, but my blood pressure is too high and I have to bring it down before my doctor is willing to operate. How I can get my blood pressure under control when I can’t walk around much? â€” Bart S., Kingston, New York
A: First, look at this as an opportunity, not a setback. High blood pressure is associated with a greatly increased risk for stroke, heart attack, kidney problems, sexual dysfunction, cognitive decline and diabetes. Lowering it by 10 mmHg reduces your chances of dying from cardiovascular disease and stroke by 25 percent and 40 percent, respectively.
So what’s your goal and how can you get there?
In general, if you’re younger than 60 and your bottom number (diastolic) is 90 or above, you should take antihypertensive medications and start a rigorous blood-pressure-lowering lifestyle routine. Although there’s some variation in recommendations for target blood pressure levels, we think you should aim for around 115/75.
Now, here’s how to lower it:
Numero Uno: Take your meds exactly as prescribed. Then, if you’re overweight, it’s essential you shed some pounds. Your first step is to kick the Five Food Felons off your plate; that means no added sugar or syrups, no grain that isn’t 100 percent whole, no trans fats and very little saturated fat.
As for physical activity? A recent study in kids found that spending more than two hours a day watching TV ups the risk for HBP 30 percent (it’s bad for adults too), and getting less than an hour of physical activity daily bumps the risk 50 percent. So you want to get movin’! With a hurting foot, you can still do upper-body work with hand weights or stretch bands and some leg exercises. Ask your doc about a safe routine for you.
Another important step: Meditate 10 minutes daily (instructions are at sharecare.com). One study found that it reduces systolic and diastolic blood pressure by approximately 4.7 and 3.2 mmHg, respectively. That should take off some pressure!