Statin Drugs: Heart Benefits Last Long
Cholesterol-Lowering Drugs Turn Back Clock on Heart Disease
WebMD News Archive
An End to Heart Disease? continued...
The 2006 study showed that people who carried certain PCSK9 gene variants
had somewhat lower cholesterol levels than people with normal PCSK9 genes --
28% lower LDL for one gene variant and 15% lower LDL for another variant.
But because they had these relatively modest LDL cholesterol reductions from
the time they were born, people who carried the gene variants had far lower
risk of heart disease -- 88% lower risk for one gene variant, and 47% lower
risk for the other.
Moreover, Domanski points out, heart disease is almost unknown in people who
live in hunter/gatherer societies that traditionally consume few saturated
fats. Once these people adopt modern lifestyles, however, they have the same
risk of heart disease as people living in Western cultures.
"It is a very different thing to prevent heart disease than to prevent
cardiac events in people who already have heart disease," Domanski says.
"If you started lowering LDL cholesterol early -- before someone has
coronary artery disease -- you could get very big effects. The potential of LDL
lowering, instituted early in life needs, much more research."
Domanski isn't suggesting that we put statin drugs in the water supply. But
he does think a clinical trial of statin drugs, in a healthy group of people 30
to 40 years old, is worth the effort. If modest LDL cholesterol reduction early
in life could cut heart disease by 50% or more, the impact would be huge.
"Dr. Domanski's very interesting suggestion is that if you were to start
treatment earlier, the benefit of preventing heart disease would be greater
than the benefit seen by starting at middle age," Cobbe says. "The
opposing argument is you would end up medicalizing very, very large sections of
the population, with potentially a quarter or a third of all adults being on
Domanski says the answer to cholesterol lowering need not be statin drugs.
can have just as big an effect. And new generations of cholesterol-lowering
drugs -- including drugs that target PCSK9 -- are on the horizon.