Charles A. Bertrand, M.D., FACP, DIM-CD (Ret.)
Associate Clinical Professor of Medicine at New York Medical College
and at the Medical University of South Carolina


Penicillin became famous around 1940. This led to the devlopment of improved penicillins as well as other antibiotics. Many consider the advent of antibiotic therapy to be one of the greatest developments in medical history —and I agree.

Now, much the same is being said about the use of statin medicines. There are a number of statins that lower total cholesterol levels as well as LDLCholesterol (the bad cholesterol ), but they have little or no effect in raising HDL cholesterol (the good cholesterol) when needed.

At present statins have been so well accepted by both doctors and patients (despite some serious tho uncommon side effects) that they are number 1 in sales. Lipitor sales were 9.2 billion dollars and the other 3 - 4 add up to another 3 to 4 billion in sales for 2003 ... almost incredibe. Two others have recently been approved by the FDA.

This week's New England Journal of Medicine (volume 350) has 4 articles about the latest developments in cholesterol management — one about treatment of patient's with low HDL's and its accompanying editorial; the others were about high dosage treatment with Lipitor and Pravastatin and its accompanying editorial. The long and short of it is that higher dosage provides greater protection against heart attacks and death than standard treatment dosage presently used. But there were only 4162 patints enrolled in this study and the average (mean) treatment period was 2 years. So do not change your treatment schedule now .... see what your doctor has to say about treatment.

Remember that once anti-cholesterol treatment is begun it goes on for years — usually many!

I think that our goals should be carefully defined and achievable (hopefully) with the smallest dose needed for success and few, if any, side effects.

For proper medical attention see your doctor on a regular basis. The above represents a general medical discussion.

The advice provided on this website is intended to be general in nature and should not be relied upon for specific treatment. If you need personal medical attention please contact your physician.

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