Heart Health

Updated 11 April 2016

International study sees statin advantages in lesser risk individuals

A major international study has shown that cholesterol-lowering statins can limit the risk of heart attack and strokes amongst older people, even if they do not have current heart conditions.

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The first major investigation of its kind shows that cholesterol-lowering statins can limit heart attacks and stroke among older people worldwide who don't have current heart conditions.

The outcomes bolster recommendations in recent studies on who should consider taking the drugs. So far the goal has been to protect against heart problems utilising a statin on its own, hypertension drugs or a mixture of the two.

The three treatments are commonly employed in high risk individuals or sometimes those with a history of cardiac disease. The participants in the study did not have heart disease and faced lower risks of developing it, and additionally the statin approach worked well.

The research included almost 13,000 men and women from twenty one nations on 6 continents. Nearly all previous studies on heart disease prevention have been in caucasian, North American individuals with elevated risks due to hypertension, unhealthy cholesterol levels or various other conditions. 

However considering heart disease is a top global killer, resulting in 18 million fatalities every year, there is a trend toward advocating pre-emptive drug treatment for more borderline patients.

Read: Should you be on statins?

The advantages of this strategy have been "seen in people from every part of the world," reported study co-author Dr. Salim Yusuf, a professor of medicine at McMaster University in Hamilton, Ontario, "This is globally applicable."

The research was published online Saturday in the New England Journal of Medicine and presented at an American College of Cardiology meeting in Chicago.
Research locations included Canada, Europe, China, South America and South Africa. About 20 percent of patients were caucasian. 

Individuals at medium risk because of age category — men were 55 and older and women were at least age 60 — and because they had another heart disease threat, including weight problems, genetics or tobacco use.

Typically, their cholesterol levels were nearly normal and moreover blood pressure was slightly under the cutoff for high blood pressure, which is 140 over 90. They were arbitrarily given one of the treatments in reduced dosages or placebos for nearly six years.

The drug treatments all reduced cholesterol and blood pressure levels however other results varied. Statin-only people were about a quarter less likely to have deadly or potentially nonfatal heart-related issues than everyone provided with placebos.

Read: Statin reduces death, heart attack

Those within the combined medication range fared moderately better and the research scientists acknowledged the statin for the benefit.

Hypertension drugs by themselves performed just as badly as placebos at stopping these events, except in the percentage of individuals who also had hypertension. The medication dosage used could possibly have been too little to provide much benefit to low-risk patients, however longer follow-up may be needed, based on a journal editorial published with the research.

Heart problems and deaths were moderately rare within the three study groups. Within the merged drug group, less than 4 percent of individuals had those outcomes, versus 5 percent of those on placebos.

Almost equivalent effects were observed in the statin-only group. Those results occurred in about 4 percent of patients on only blood pressure medicines and in those on placebos. 

Read: Statins linked to muscle pain, sprains

Patients on statins had slightly more weakness and muscle pain  known statin side effects, than those on dummy pills. Statin patients also had slightly more cataract surgeries but the researchers said it isn't known if the drug played a role.

Dr. Clyde Yancey, cardiology chief at Northwestern Medicine in Chicago, said the outcomes add significant emphasis favoring drug treatment for lower-risk individuals, but stressed that lifestyle steps including healthy eating and exercise ought to be added. He wasn't involved in the study.

The study utilized 10 milligrams daily of rosuvastatin, distributed as a generic or under the name Crestor. The editorial authors said other statins would likely have similar results. Crestor's maker, AstraZeneca, and the Canadian Institutes of Health Research paid for the research.

Yusuf reported obtaining grants from both; and several co-researchers reported grants and personal fees from the company and other drugmakers. The blood pressure drugs were candesartan, sold as a generic and by AstraZeneca as Atacand; and hydrochlorothiazide, a generic diuretic. 

Read more: 

Heart attack 

Heart-valve disease 

Coronary artery disease (CAD)


Online:

Journal: http://www.nejm.org

Cardiology meeting: http://www.acc.org

Follow AP Medical Writer Lindsey Tanner at http://www.twitter.com/LindseyTanner. Her work can be found at http://bigstory.ap.org/content/lindsey-tanner


AP