Cholesterol Lowering Drugs Can Prevent Heart Attacks and Strokes Even in Those with Low Cholesterol

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Cholesterol Treatment Drug Statin

A class of drugs known as the 'statins' that is already widely used to treat high cholesterol levels would benefit more people if targeted at all people with diseased arteries, regardless of their cholesterol level, according to findings published online in The Lancet on 27 September.

A study jointly coordinated by scientists from the Clinical Trial Service Unit (CTSU) at Oxford and the National Health Medical Research Council Clinical Trials Centre at the University of Sydney combined detailed results from more than 90,000 participants in 14 previously completed trials involving statin treatments. It shows that many people with lower cholesterol levels could benefit from statin treatment.

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Statins are known to be effective in preventing the number of heart attacks and strokes in a wide range of patients who are at high risk of such disease. However, most doctors consider statin treatment only when the blood cholesterol level is above a certain threshold. As a consequence, patients with narrowed blood vessels are generally not treated with a statin if their blood cholesterol is below this threshold level.

The trial found that not only did people with lower cholesterol levels benefit from statins, but the biggest benefits occur in those patients with the largest absolute reductions in cholesterol after treatment, largely irrespective of their original cholesterol level.

Dr Colin Baigent in CTSU said: 'This study shows that statin drugs could be beneficial in a much wider range of patients than is currently considered for treatment. What matters most is that doctors identify all patients at risk of a heart attack or stroke, largely ignoring their presenting blood cholesterol level, and then prescribe a statin at a daily dose that reduces their cholesterol substantially. Lowering the bad 'LDL' cholesterol by 1.5 mmol/L units with a statin should reduce the risk of a heart attack or stroke by at least one third.'

The study suggests that many patients given a statin would experience greater benefits if doctors aimed to achieve larger reductions in cholesterol levels. Statins are often prescribed in relatively small doses which may only reduce cholesterol modestly, but the results of the study indicate that the benefits of statins are directly proportional to the size of the reduction in cholesterol produced by treatment

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