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Experts Say More People Should Take Statins

Posted on: Monday, 18 October 2004, 06:00 CDT

(AP) -- Perhaps no medicine today is so widely regarded as a wonder drug as the cholesterol-lowering statin. From Zocor to Lipitor to Pravachol, statins are top sellers in a country where half of American adults have high cholesterol.

In Britain, they recently became available over the counter, and there are efforts afoot in the United States to do the same.

This summer, a U.S. advisory panel set recommended cholesterol levels even lower, encouraging millions more Americans to take statins. But because all but one member of that panel receives money from the makers of those drugs, some consumer advocates wonder about the credibility of the latest advice.

Still, no one questions the overall value of these drugs, which quickly and drastically lower the cholesterol that builds up in blood vessels, thus preventing heart attacks and strokes.

The first statin, Mevacor, came on the market in 1987. Now there are five others in the United States. About 13 million Americans take statins - roughly one-third of the number for whom they're recommended.

The most famous recent example is former President Bill Clinton, who was prescribed a statin for high cholesterol when he left office several years ago but who stopped taking it at some point. On Labor Day, he had a quadruple bypass operation for arteries so severely clogged that doctors said he was in grave danger of a major heart attack.

Proponents of statins, such as the National Lipid Association, a largely industry-funded group, say Clinton's case shows the need for educating more doctors to treat cholesterol more aggressively.

"How in the heck did he get something that could be prevented? The president's doctors didn't even know how to manage lipids," said the group's executive director, Christopher Seymour.

A federally funded program, the National Cholesterol Education Program, was formed in 1985 to help educate Americans about this risk factor. Its revised guidelines, issued in July, have been criticized by some as perhaps too aggressive for certain groups like the elderly, women and people with diabetes.

They advise people at high risk of a heart attack to get their level of LDL or "bad" cholesterol to 70, instead of 100, the previous target. The guidelines urge people at moderate-to-high risk to aim for 100 versus the previous target of 130.

The drugs and their makers are Merck's lovastatin (Mevacor) and simvastatin (Zocor); Bristol-Myers Squibb's pravastatin (Pravachol); Novartis Pharmaceuticals' fluvastatin (Lescol); Pfizer's atorvastatin (Lipitor), and AstraZeneca's rosuvastatin (Crestor).

Side effects are very rare, but can include severe muscle weakness. The federal Food and Drug Administration has warned doctors to be careful about prescribing statins, particularly Crestor, in certain patients at higher risk of complications, including certain Asians, the elderly, and people with thyroid or kidney problems.

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