Endocrine Abstracts

Xerostomia can be classified into two different types. One type is associated with severely reduced salivary secretion. The other involves normal salivary function yet reduced viscosity of saliva or reduced mucin concentration within the saliva, a common finding in elderly people. Studies show that xerostomia is the most common oral side-effect of cardiovascular medication. Statins are common cardiovascular drugs used to treat hypercholesterolemia. A 55-year-old Asian lady, non-smoker, and a teetotal with bilateral xanthelasma was commenced on simvastatin in August 2011 due to hypercholesterolemia and elevated lipoprotein a. She was initially started on nicotinic acid as it is the most effective treatment for elevated lipoprotein a however as it caused her adverse side effects it was stopped and she was subsequently commenced on 20 mg simvastatin, increased to 40 mg after 4 weeks. Unfortunately she started to develop oral dryness, within a few weeks. This was present throughout the day, as well as the night. Owing to reduced salivary flow rate as a result of snoring and mouth breathing during sleep, nocturnal oral dryness is a normal entity, yet day-time oral dryness is a finding associated with systemic diseases such as Sjögrens disease, diabetes, vitamins A and E deficiencies for which she was negative or pharmaceutical drug use, one of which are statins. She was temporarily changed from simvastatin to atorvastatin due to persistently high LDL cholesterol and the high risk of both CVD and PVD associated with high lipoprotein A. atorvastatin was also stopped for 4 weeks and it substantially did help to minimize her xerostomia. Unfortunately side effects such as xerostomia remain unreported by patients owing to their perception as a minor side effect. This indicates that studies underestimate its true prevalence in statin treatment therefore more studies are required on the association between statins and xerostomia.