A large new study suggests millions of people could benefit from taking cholesterol-lowering drugs known as statins, even if they have low cholesterol, because the drugs can significantly lower their risk of heart attacks, strokes and death.
“The study findings have the potential to change the very concept of primary prevention,” said Dr. Christie M. Ballantyne, M.D., of Methodist DeBakery Heart and Vascular Center in Houston.
“Why wait until someone develops heart disease? Preventive treatment makes sense,” said Ballantyne.
AstraZeneca, maker of Crestor, generic name rosuvastatin, funded The Jupiter Trial, which was recently presented at the American Heart Association meeting in New Orleans.
The Jupiter Study (Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin) was a long-term, randomized, double-blind, placebo-controlled trial that involved nearly 18,000 people worldwide that tested rosuvastatin 20 mg in men and women who did not have a history of high cholesterol or heart disease.
What they did have was high levels of a protein called high-sensitivity C-reactive protein, or CRP, which indicates arterial inflammation in the body.
Researchers found the risk of heart attack was cut by more than half for people who took statins. Those people were also nearly 50 percent less likely to suffer a stroke or need bypass surgery, and 20 percent decrease in death from all causes compared to those who were given a placebo.
What was supposed to be a five-year trial was stopped last March after less than two years because the statin was considered so beneficial by an independent safety monitoring board.
Scientists say the research could help address a long-confounding statistic – half of heart attacks and strokes occur in people that have low cholesterol.
“The study results are impressive. Mortality was reduced by 20 percent in less than 2 years and all other events were reduced by 40 to 50 percent,” said Dr. Carl Lavie, director of cardiac rehabilitation and prevention at Ochsner Heart and Vascular Institute in New Orleans.
In the study: one serious heart event was avoided for every 25 patients given Crestor. And one death was prevented for every 180 patients. Under current cholesterol guidelines, the participants would not have been on statin medications.
Of particular significance to Dr. Ballantyne, was data that showed the same live-saving benefits in women, an undertreated portion of the population, as men.
“Heart disease is the number one cause of pain, suffering and death in the United Sates. If a more aggressive approach can help to change this, I’m all for it,” Ballantyne said.
Dr. Paul M. Ridker, leader of the Jupiter study and director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital, said expanding stating use could prevent as many as 250,000 heart attacks, strokes and vascular procedures or cardiac deaths over five years.
Experts not involved in the study said 16 to 20 million Americans currently take statins and several million more probably should be as well.
The study is published online in the November 9 issue of the New England Journal of Medicine. #