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Statin Drug Could Cut Heart Attacks By a Third

Posted on: Tuesday, 27 September 2005, 18:00 CDT

LONDON: Anybody at risk of heart attack or stroke should be prescribed a statin drug, regardless of cholesterol levels. Analysis by British and Australian scientists has shown that the benefits of the drugs are not limited to those who have high cholesterol.

Taking statins daily can cut the risk of heart attack and stroke by about a third, a team from the Medical Research Council, in Oxford, and the Clinical Trials Centre, at the University of Sydney, concludes. The study also sets aside fears that the use of statins increases the risks of cancer. Over five years there was no evidence of this, the team reports in the online edition of The Lancet.

A second study, of US army veterans and published in Archives of Internal Medicine, suggests that statin use by elderly men reduces the risk of bone fractures by more than a third. The studies add to the evidence that statins can provide significant benefits.

The Oxford and Sydney team looked at 14 randomized trials of statins, involving more than 90,000 patients. Benefits appeared in the first year of use and increased, and the benefits were the greatest in those in whom cholesterol levels fell the farthest, regardless of where the levels started.

Colin Baigent, who co-ordinated the Oxford team, said: "This study shows that statin drugs could be beneficial in a much wider range of patients than is currently considered for treatment. What matters most is that doctors identify all patients at risk of a heart attack or stroke, largely ignoring their present blood cholesterol level, and then prescribe a statin at a daily dose that reduces their cholesterol substantially. Lowering the 'bad' LDL cholesterol with a statin should reduce the risk of a heart attack or stroke by at least one third."

At present doctors weigh up several factors when assessing the risk of a heart attack, with blood pressure, cholesterol level, obesity and smoking status being the most important. As statins are cholesterol-lowering drugs, doctors may be disinclined to prescribe them in patients who have other risk factors but whose levels of LDL cholesterol are normal. The new analysis indicates that this is a mistake.

Anthony Keech, who co-ordinated the team in Sydney, said: "Statins are often prescribed in relatively small doses, which may reduce cholesterol only modestly. Our results indicate that the benefits of statins appear directly proportional to the size of the reduction in cholesterol produced by treatment. So bigger cholesterol reductions with more intensive treatment regimens should lead to greater benefits."

Rory Collins, an author of the study, said: "Statins are very safe. There is no good evidence that statins cause cancer, nor do they increase the risk of other diseases. The small excess of serious muscle problems is far outweighed by the large benefits on heart attacks and strokes."

John Simes, another author of the study, said: "The benefits of statin treatment were seen in all the many different patient groups studied, including women, the elderly, individuals with diabetes and those with and without prior heart attack or stroke. The largest benefits were seen among those at greatest risk of a vascular event."

Source: China Daily; North American ed.

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