January 14, 2009

New Analysis Finds Statins Would Benefit 77 Million

New research shows that an additional 19 percent of men over the age of 50 and women over the age of 60 would benefit from taking statins, one of the top selling drugs in the world.

Previous research, known as the Jupiter study and funded by AstraZeneca, found that the statin Crestor significantly reduced deaths, heart attacks and strokes in those with normal cholesterol levels but elevated levels of C-reactive protein, an indicator of arterial inflammation associated with serious heart disease.

The latest study, which was not funded by the pharmaceutical industry, sought to determine whether people with high levels of C-reactive protein would experience lower rates of heart disease if they took AstraZeneca's Crestor.

Current U.S. guidelines suggest about 58 percent of men over the age of 50 and women 60 and older, or about 34 million people, would reduce their risk of stroke and heart attack by taking statins.

Dr. Erica Spatz of Yale University and her colleagues used data from the 1999"“2004 National Health and Nutrition Examination Survey to determine how many additional people might be also helped by statins when taking C-reactive protein levels into account.  

The survey showed that 33.5 million, or 24.4 percent, of older Americans (men age 50 years and older and women age 60 years and older) are currently taking a statin.

However, the researchers found that an additional 19.2 percent of men and women in those age groups, or about 11 million people, would also benefit from taking the drug.

The results, when combined with current guidelines, mean that 77 percent of Americans in those age groups, or roughly 45 million people,  should take statins, the researchers said.

"Based on our analysis, more than 44.7 million older Americans might have an indication for statin therapy when you consider those who already meet current guidelines for statin therapy and those who might be eligible based on the criteria proposed in JUPITER," said Erica S. Spatz, M.D., the study's lead author and an internist and fellow in the Robert Wood Johnson Clinical Scholars Program at Yale University, New Haven, Conn.

"That's nearly 80 percent of this segment of the population who could potentially be recommended a statin therapy if those criteria were adopted into guidelines," said Spatz, who was not involved in the Jupiter trial. "¨

"If the effects of this study bear out, the majority of people would be recommended to take a statin," Spatz said during an interview with Reuters.

However, fewer than half of those who could benefit from the drug under existing guidelines are actually taking it, she added.

"You need to use caution as we move ahead, especially because this affects so many people."

The Jupiter study, which was presented at a meeting of the American Heart Association in November, found that Crestor, also known as rosuvastatin, reduced the risk of stroke, heart attack, the need for bypass or angioplasty procedures and cardiovascular death by 45 percent over less than two years.

"Certainly the Jupiter findings were intriguing and they will be evaluated as any future revisions are considered for treatment guidelines for reducing cardiovascular risk," said Dr. Timothy Gardner, president of the American Heart Association, in a statement.

"This additional analysis of that data provides useful information about how many individuals would meet the JUPITER inclusion criteria. A more in-depth study of further implications, including cost-analysis, will be critical in future decision-making processes about preventive measures for the population as a whole. All of this will need to be carefully considered in the context of available resources and the most effective ways to make the most positive impact possible in reducing heart disease and stroke.""¨

The latest research was published in the journal Circulation: Cardiovascular Quality and Outcomes.


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