Antioxidants and Statin Use

Antioxidant Position Statement from Cooper Aerobics Center

Topic: A news story released August 11, 2001 indicated that a new study found that antioxidants could block the response of HDL cholesterol to Zocor-niacin therapy in patients with coronary artery disease and low HDL cholesterol. The report was based on a study conducted at The University of Washington at Seattle, which was published in the journal Atherosclerosis, Thrombosis and Vascular Biology.

Dr. Kenneth Cooper and colleague, Iswarlal Jialal, M.D., Ph.D., distinguished professor at the University of Texas Southwestern Medical School and chairman of the subcommittee on vitamin C for the Institute of Medicine, had these comments:

• There is no study that shows detrimental effects when combining antioxidants and statin (cholesterol- lowering) drugs. In this study, they did not include a group that looked only at antioxidants and Zocor. In fact, there is preliminary evidence from the Heart Protection Study at Oxford where they are looking at 20,000 patients taking antioxidants and Zocor that shows that the antioxidants have no effect on the drug's ability to raise HDL cholesterol. This study will be presented at the American Heart Association at the end of the year.
  
  
• The recent study from The University of Washington has not changed Dr. Cooper and the Cooper Clinic's stance on antioxidant supplementation. They are as follows:
• 1000 mg of vitamin C, (500 mg taken twice daily)
• 800 IU of vitamin E (d-alpha tocopherol)
• 5,000 IU of beta carotene (a total of 25,000 IU, but only 5,000 from a supplement)
• 100 mcg of selenium

1) Zocor-niacin group 2) Zocor-niacin-antioxidant group 3) antioxidants group 4) placebo group. Each group had approximately 40 patients, which is too few to use to draw conclusions.

• The study found that in the Zocor-niacin group, the HDL (good) cholesterol increased by 25%, but the Zocor-niacin-antioxidant group only had an 18% increase in HDL cholesterol. The difference between these groups is small and there could be other factors that may explain the variance, such as compliance in taking niacin. Niacin is difficult to tolerate due to side effects, especially at the dosage used in this study.
  
  
• Both of the Zocor-niacin group and the Zocor-niacin-antioxidant group had significant reductions in total cholesterol and LDL (bad) cholesterol.
  
  
• Nicotinic acid (niacin) may be interfering with Zocor's ability to raise HDL cholesterol.
  
  
• The Cooper Clinic does not discourage the combination of Zocor and antioxidants. However, if you are taking niacin, you may want to check with your physician to see if your HDL cholesterol has been affected.