Statins May Perform Better as a Solo Act
Combination Therapy for Lowering Cholesterol Not Yet Proven to Be Superior to Statins Alone
Aug. 31, 2009 -- Statins may do their best work at lowering cholesterol
levels alone, according to a new review of research on the popular drugs.
More than 28 million Americans have some form of heart disease, and doctors
often prescribe statin drugs to lower dangerous low-density lipoprotein (LDL)
cholesterol levels. High LDL cholesterol levels increase the risk of arteries
becoming blocked and triggering a heart attack or stroke.
Even so, researchers say only about one-third of people with high
cholesterol are able to lower their LDL cholesterol to healthy levels and that
number is even lower among those with established heart disease.
That prompts many doctors to try combining cholesterol-lowering statin
therapy with other non-statin medications in an attempt to further lower
But researchers analyzed 102 published studies on the topic and found no
benefit of combination therapy at reducing the risk of death, heart attack,
stroke, or the need for bypass surgery over using high doses of statins
The studies were of relatively short duration, often did not employ maximal
doses of statin drugs in the combination regimens, and did not examine all
possible medication combinations. These limitations affect the ability to make
firm conclusions regarding the true use of combination therapy.
Nevertheless, the proven benefits of using statin drugs alone in reducing
the risk of heart attack and stroke suggest that “the benefits of additional
therapies need to be clearly defined along with attendant risks and costs
before advocating widespread use of combination treatment,” writes researcher
Mukul Sharma, MD, MSc, of the Canadian Stroke Network in the Annals of