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Statin Benefits Patients With Low Cholesterol

Crestor Users Cut Cardiac Deaths in Half
By
WebMD Health News

crestor_as_preventative_medicine.jpg

Nov. 10, 2008 -- Millions of Americans take statins to lower their cholesterol, but dramatic findings from a study of the statin drug Crestor suggest that millions more might benefit from treatment.

The findings may also lead to a more important role for the blood test high-sensitivity C-reactive protein (hsCRP) in assessing cardiovascular risk.

Related Medications

More information on common Cholesterol drugs from RxList:

 

The study included about 18,000 apparently healthy men and women with normal cholesterol but higher than normal levels of high sensitivity C-reactive protein, a marker of inflammation that has been linked to heart disease.

Originally planned as a four-year trial, the study was stopped late in March after most participants had taken the statin for less than two years.

People who took Crestor had half as many major cardiovascular events as people assigned to the placebo arm of the trial.

The study was funded by Astra-Zeneca, which makes Crestor. It was presented in New Orleans at the American Heart Association's Scientific Sessions and it also appears in the Nov. 20 issue of The New England Journal of Medicine.

"Physicians can no longer assume that a patient with low cholesterol has a low risk for a heart attack or stroke," lead researcher Paul M. Ridker, MD, of Boston's Brigham and Women's Hospital, tells WebMD.

Statins Benefit "Low-Risk" Patients

Statins are generally prescribed only for people with high cholesterol or those who have borderline high cholesterol and other risk factors for heart attack and stroke, such as diabetes or established heart disease.

But as many as half of all heart attacks and strokes occur among people without these risk factors who have LDL cholesterol levels that are below recommended thresholds for statin treatment.

The newly reported trial was designed to explore whether statins might also benefit these people.

All of the study participants had LDL cholesterol levels of less than 130 milligrams per deciliter when they entered the trial, and none had known diabetes or heart disease. But they did have high-sensitivity CRP levels of 2.0 milligrams per liter or higher.

Blood hsCRP levels of less than 1 milligram per liter are indicative of low cardiovascular risk, while 1 to 3 milligrams per liter indicates moderate risk, and greater than 3 indicates high risk, Ridker says.

About 9,000 study participants were treated with 20 milligrams per day of Crestor and an equal number of participants took a placebo.

When the trial was stopped after a median follow-up of 1.9 years, statin users had lowered their LDL cholesterol by an average of 50% and their hsCRP by 37%.

There were also half as many heart attacks, strokes, and deaths from cardiovascular causes among the participants taking the statin. In all, 0.9% of statin users had one of these events, compared to 1.8% of placebo users.

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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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