Home' Australian Pharmacist : Australian Pharmacist October 2014 Contents Australian Pharmacist October 2014 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
COUNSELLING IN PRACTICE
1. High cholesterol is generally caused
a) an autosomal dominant disorder that
causes elevations in LDL.
b) age-related decline in hepatocyte
c) genetic susceptibility combined with
d) a deficiency in HMG-CoA reductase in
2. Choose the CORRECT statement.
a) A total cholesterol level <5.5 mmol/L is
not a risk factor for atherosclerosis.
b) Excessive dietary fat intake, obesity,
and sedentary lifestyle all contribute to
c) Cardiovascular disease from
atherosclerosis is associated with
elevated HDL and triglyceride levels.
d) The prevalence of high cholesterol
increases after the age of 55 years in
a) are equally effective at lowering LDL,
VLDL and triglyceride levels.
b) have a maximal effect on cholesterol
concentrations within two weeks of
initiation or a dose increase.
c) have a greater protective effect after 1–2
years of continuous use.
d) are used short-term to reduce
cholesterol levels to below the
cardiovascular risk threshold.
4. Choose the CORRECT statement
regarding the safety of statins.
a) Statins have been associated with
progressive cognitive decline and
b) Mild muscle discomfort is an
uncommon side effect, occurring in less
than 5% of people taking statins.
c) Statins are associated with a 19%
increased risk of new-onset diabetes.
d) Diabetes, advanced age and high statin
doses are associated with an increased
risk of muscle adverse effects.
5. Important advice for people
commencing statin therapy includes:
a) Statins are one of the most effective
strategies for reducing the risk of heart
attack and stroke.
b) Statins are generally well-tolerated,
and most side effects are mild and
c) Statins provide an added benefit but
do not replace eating a healthy diet or
keeping physically active.
d) All of the above.
5. McKenney JM. Pharmacologic characteristics of statins.
Clin Cardiol 2003; 26(Suppl 3):32–38 .
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Pharmacology. 7th edn. New York: Elsevier Inc.; 2012.
7. NPS Medicinewise. Keep taking your statins: benefits
outweigh risks. Medicinewise Living, 31 Oct 2013. At:
8. US Food and Drug Administration. FDA expands advice
on statin risks, Jan 2014. At: www.fda.gov/downloads/
9. NPS Medicinewise. Statins – frequently asked questions.
Fact Sheet – Reduce risk by lowering cholesterol, Feb 2014.
10. Hilmer S, Gnjidic D. Statins in older patients. Aust Prescr
11. Alzheimer ’s Australia. Statins and dementia: official
statement, 01 March 2012. At: www.fightdementia.org.
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harms of individual statins: A study-level network meta-
analysis of 246,955 participants from 135 randomized
controlled trials. Circ Cardiovasc Qual Outcomes 2013;
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benefits and diabetes risks of statin therapy in primary
prevention: an analysis from the JUPITER trial. Lancet 2012;
14. National Vascular Disease Prevention Alliance. Guidelines
for the management of absolute cardiovascular disease
risk. 2012. At: http://strokefoundation.com.au/site/media/
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statins in managing cardiovascular risk. Vasc Health Risk
16. NPS Medicinewise. Statins revisited: appropriate patient
selection is key. Health News and Evidence, 16 Sep 2013.
17. Baigent C, Blackwell L, Emberson J, et al. Efficacy and
safety of more intensive lowering of LDL cholesterol: a
meta-analysis of data from 170 000 participants in 26
randomised trials. Lancet 2010; 376(9753):1670–81.
18. Taylor F, Huffman MD, Macedo AF, et al. Statins for the
primary prevention of cardiovascular disease. Cochrane
Database of Systematic Reviews 2013, Issue 1. Art. No.:
CD004816. DOI: 10.1002/14651858.CD004816.pub5.
19. NPS Medicinewise. Managing lipids – reducing
cardiovascular disease risk. MedicineWise News, 01
Feb 2011. At: www.nps.org.au/publications/health-
20. Forey BA, Fry JS, Lee PN, et al. The effect of quitting
smoking on HDL-cholesterol – a review based on within-
subject changes. Biomarker Research 2013; 1:26.
21. National Heart Foundation of Australia. Fats & cholesterol.
22. Rosenson RS, Baker SK, Jacobson TA, et al. An assessment
by the Statin Muscle Safety Task Force: 2014 update. J Clin
Lipidol 2014; 8:S58–S71.
23. Adverse Drug Reactions Advisory Committee (ADRAC).
Australian Adverse Drug Reactions Bulletin 2004;23(1). At:
24. Parker BA, Capizzi JA, Grimaldi AS, et al. Effect of statins on
skeletal muscle function. Circulation 2013; 127:96–103.
25. Golomb BA, Evans MA, Dimsdale JE, et al. Effects of
Statins on Energy and Fatigue With Exertion: Results
From a Randomized Controlled Trial. Arch Intern Med
26. Cardiovascular Expert Group Therapeutic guidelines:
cardiovascular. Version 6. eTG complete. Melbourne:
Therapeutic Guidelines; 2012.
27. National Heart Foundation of Australia. Improving
adherence in cardiovascular health, Apr 2010. At: www.
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they used appropriately? Cardiovascular disease series no.
27. Cat. No. 36 . Canberra: AIHW; 2007.
29. National Heart Foundation of Australia. Data and statistics
– Information for professionals. At: www.heartfoundation.
30. National Vascular Disease Prevention Alliance (NVDPA).
Australian absolute cardiovascular risk calculator. 2012.
• Statins suppress cholesterol synthesis
by inhibiting the enzyme HMG CoA
• The choice and intensity of lipid (and
other risk factor) management should
be determined by assessing a person’s
absolute cardiovascular risk.
• People at greatest risk derive the
greatest benefit from intensive
treatment with lipid lowering and
• The mortality and cardiovascular
benefits of taking a statin are
considered to greatly outweigh the
possible risk of developing diabetes.
1. Carrington MJ, Stewart S. Australia’s cholesterol crossroads:
An analysis of 199,331 GP patient records. Melbourne:
Baker IDI Heart and Diabetes Institute; 2011.
2. Dyslipidemia [revised Oct 2013] The Merck Manual. At:
3. Citkowitz E. Polygenic Hypercholesterolemia [revised
Jan 2012]. Medscape Reference. At: http://emedicine.
4. Citkowitz E. Familial hypercholesterolemia [revised
Aug 2014]. Medscape Reference. At: http://emedicine.
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