Role of statins in preventing heart attack and stroke
Millions more people at risk of having heart disease and stroke could benefit from taking statins, a class of lipid lowering drugs, Johns Hopkins doctors reported in a new study. It is well-known that statins can help prevent subsequent heart attacks and strokes in patients who have already had one of these cardiovascular events. Additionally, statins have been shown to have a protective effect for patients who have not yet had a heart attack or stroke but are at high risk for developing cardiovascular disease. Consequently, doctors prescribe these drugs both to patients with established cardiovascular disease, as well as those with high cholesterol and other risk factors for developing cardiovascular disease such as diabetes. However, there is an ongoing debate about patients who do not yet have the disease should also receive statins. One study from Harvard Medical School revealed that there is no data to suggest they help men over 69 who have only a moderate risk of getting problems in the future and women, say scientists. The Harvard researcher behind the study concluded the drugs should no longer be regularly prescribed to these two groups of patients. But most of the study suggests use of statins could prevent millions of heart attacks and strokes. Peter Weissberg, Medical Director at the British Heart Foundation, expressed that the benefits of statins in reducing blood cholesterol and preventing heart attacks in patients known to have artery disease are beyond doubt. About half of all cardiovascular events occur in patients who do not have high cholesterol, and about 20 percent of these events occur in people who have no identifiable cardiovascular disease risk factor. Until recently, doctors have not been sure if any of these patients might also benefit from statin therapy. Researchers found that they found that statins protect against heart attacks and strokes even in older adults without known cardiovascular disease or diabetes and with low cholesterol, below 130 mg/dl — a group that is not usually prescribed statins — as long as these patients also had high levels of C-reactive protein (CRP), a blood marker for inflammation. Recent research has shown that inflammation plays an important role in initiating cardiovascular events, but at-risk patients are not routinely tested for CRP levels. "We are showing that doctors may be able to prevent thousands of heart attacks, strokes and deaths each year if we expand statin-prescribing criteria to include C-reative protein levels, something we can assess as part of a simple blood test," says lead researcher Michos. The team points out in the study, published in the the Journal of the American College of Cardiology prescribing statins to older adults using this new criteria that incorporates CRP would prevent about 260,000 cardiovascular events over five years. The Heart Protection Study Collaborative Group at Oxford University, writing in the British Medical Journal last year, claims those as young as 35 with a 1 per cent risk of a heart attack or stroke could benefit. They claimed if they take cholesterol-lowering drugs for the next 35 years, they would gain nine months of extra life expectancy.
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