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Statin Drugs: Heart Benefits Last Long

Cholesterol-Lowering Drugs Turn Back Clock on Heart Disease
By
WebMD Health News
Reviewed by Louise Chang, MD

Statin Lowers Heart Disease

Oct. 10, 2007 -- Men who took statins for five years had fewer heart deaths and heart attacks 10 years later -- even though most had stopped taking the cholesterol-lowering drugs.

The intriguing finding suggests that relatively small, early reductions in bad LDL cholesterol can have very large benefits later in life.

Study investigator Stuart Cobbe, MD, professor of medical cardiology at the University of Glasgow, Scotland, says the finding was something of an accident.

"Almost by chance we had the opportunity to look at the long-term effect of a five-year period of treatment with statins -- without further ongoing treatment -- to see how that altered the trajectory of heart disease," Cobbe tells WebMD.

What happened?

"The very interesting finding is the five-year treatment had a beneficial effect that was clear 10 years later," Cobbe says. "We put the clock back on coronary disease in the people who received treatment."

These results, taken together with other recent findings, are very exciting to Michael Domanski, MD, chief of the atherothrombosis and coronary artery disease branch of the National Institutes of Health. Domanski's editorial comments accompany the study by Cobbe and colleagues in the Oct. 11 issue of the New England Journal of Medicine.

"If you start early, and keep LDL cholesterol down over a lifetime, you may be able to prevent heart disease," Domanski tells WebMD.

Lower LDL Cholesterol = Less Heart Disease, Death

The study by Cobbe and colleagues, called the West of Scotland Coronary Prevention study, enrolled 6,595 middle-aged men with high cholesterol from 1989 through 1991. None of the men in the study had a previous heart attack.

It was supposed to test a then-new idea: that Pravachol, one of the cholesterol-lowering statin class of drugs, might prevent heart disease (other statins available in the U.S. are Crestor, Lescol, Lipitor, Mevacor, and Zocor). At the time, statins were prescribed only for patients who already had heart disease.

Pravachol treatment cut their average LDL cholesterol levels by 26% -- from 192 mg/dL to 142 mg/dL. Over the five-year study period, these men had 31% fewer heart attacks or deaths from heart disease.

Because most doctors still thought statins should be prescribed for men with existing heart disease, fewer than 40% of the men used statin drugs after the study ended. Nevertheless, the researchers kept tabs on the men for another 10 years.

This gave them the chance to see whether statin treatment had any lasting benefit. It did. Men who got inactive placebo pills during the study had a 15.5% chance of heart attack or heart death 10 years after the study ended. Those who got five years of statin treatment had only an 11.8% chance of heart attack or heart death. They also had a lower risk of heart disease.

Is This Normal? Get the Facts Fast!

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Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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