Cholesterol Drugs Help Most Heart Patients

Statins reduce the risk of vascular events in even low risk patients

(RxWiki News) Cholesterol-lowering statins, typically prescribed only to patients at elevated risk of heart attack or stroke, also appear to benefit patients with a low risk of suffering adverse heart events.

The Cholesterol Treatment Trial (CTT) found that statins to lower LDL cholesterol reduced the risk of adverse heart events by 20 percent per LDL cholesterol point in patients with heart disease, as well as in those who were considered low risk for future vascular events.

"Talk to your cardiologist about the benefits of statins."

Colin Baigent, lead author and a professor in the Clinical Trial Service Unit and Epidemiological Studies Unit at the University of Oxford in England, said that the benefits found greatly outweigh any known hazards of taking statin therapy.

Under current US and UK guidelines, low risk patients are not eligible to take statins.

During the review study, investigators analyzed 27 randomized trials that included 175,000 participants taking either statins or an inactive drug given to compare effectiveness. Some of the trials compared varying statin doses.

Participants of the trials were followed an average of nearly five years.

In participants whose risk of a major vascular event within the next five years was less than 10 percent, the medication still provided a benefit, researchers concluded.

Investigators said the findings suggest the guidelines for who should take statins may need to be revisited.

Shah Ebrahim, DM, and Juan P Casas, MD, PhD, from the London School of Hygiene and Tropical Medicine, wrote in a commentary published in The Lancet, that the study confirms the effectiveness of statins in primary prevention.

They said statins should be considered for all patients over age 50, regardless of their heart risk.

"In primary care, long-term reductions of the order of 1 mmol/L LDL cholesterol might be difficult to achieve. Two-year adherence rates to statins in people without evidence of cardiovascular disease might be as low as 25 percent, and use of lower than optimum doses of statins seems to be resistant to an audit-education intervention for doctors," they noted in the editorial.

"The CTT analysis provide reassurance for general practitioners to prescribe higher doses of statins to achieve greater benefit, and dissipate uncertainty about any potential serious adverse risks of statins, which might account for prescription of lower than optimum doses."

The study was funded by the British Heart Foundation; UK Medical Research Council; Cancer Research UK; European Community Biomed Programme; Australian National Health and Medical Research Council; and the National Heart Foundation, Australia. The research was recently published in The Lancet.

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Review Date: 
May 17, 2012