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Statin Rx should be Reserved for Subset of Patients

Kathleen Blanchard's picture

Taking statins to ward off heart attack and other cardiovascular events may not be right for everyone. Researchers from Johns Hopkins presented findings at the AHA Scientific Sessions 2010 revealing that 95 percent of heart attacks, stroke and other heart related deaths occur in patients with calcium buildup in the blood vessels. The scientists suggest statins may be overprescribed and should be reserved for a subset of patients that would benefit the most.

Statins not Always the Solution for Preventing Heart Disease

"Our results tell us that only those with calcium buildup in their arteries have a clear benefit from statin therapy, and those who are otherwise healthy and have no significant calcification should with their physician focus on aggressive lifestyle improvements instead of early initiation of statin medications," says study lead investigator Michael Blaha, M.D., M.P.H.

Dr. Blaha says, "While statin therapy can benefit healthy men and women with normal or even low cholesterol levels, it certainly is not the case that all adults should be taking it to prevent heart attack and stroke, because half are at negligible risk of a sudden coronary event in the next five to 10 years.”

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The findings come from the Johns Hopkins-led Multi-Ethnic Study on Atherosclerosis, or MESA, using the same criteria as the JUPITER (Justification for the Use of Statins in Primary Prevention) that evaluated Rosuvastin for preventing coronary events in individuals with high CRP levels – a marker of inflammation. The MESA participants were ethnically diverse.

After comparing statistics the study found few heart attacks would have been prevented unless there was some calcium in the blood vessels. CRP was no help for predicting who is really at risk for suffering a heart attack even when taking into account well established risk factors. The current study participants had varying CRP levels.

Roger Blumenthal, M.D., a professor and director of the Ciccarone Preventive Cardiology Center at Johns Hopkins says, "Statin therapy should not be approached like diet and exercise as a broadly based solution for preventing coronary heart disease”, and should be reserved for those at greatest risk, especially individuals with high calcium scores. If your doctor recommends, Blumenthal also says patients should get a coronary calcium CT scan in addition to monitoring their own individual risk factors.

Johns Hopkins