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Heart Disease Health Center

Intensive Statin Therapy Stops Plaque Buildup

Higher Doses of Cholesterol-Lowering Drugs Fight Atherosclerosis Better
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March 2, 2004 -- Less may be more when it comes to fashion, but more may be more when it comes to fighting artery-clogging plaque.

A new study shows intensive therapy with high doses of statin drugs is more effective at slowing the progression of plaque buildup in the arteries than more moderate doses.

Researchers say statin drugs are known to help lower cholesterol levels and help prevent heart-related deaths, but the optimal approach in using the drugs to treat people with existing atherosclerosis (plaque buildup in the arteries) has not been determined.

They say the finding suggests that a more aggressive cholesterol-lowering therapy may be required to get the best results in slowing the progression of atherosclerosis than is currently recommended by national and international guidelines.

The results appear in the current issue of The Journal of the American Medical Association.

Intensive Statin Therapy Protects Arteries

In this study, researchers compared the effects of intensive statin therapy using 80 mg daily of Lipitor vs. a more moderate approach using 40 mg of Pravachol in more than 500 adults with atherosclerosis.

After 18 months of treatment, researchers found those who received the higher dose had greater reductions in "bad" LDL cholesterol levels than those who received the lower dose.

The intensive therapy group also experienced a greater drop in C-reactive protein levels, which is a measure of inflammation used to predict heart risks.

But researchers say the most significant finding was that plaque buildup within the arteries stalled among the patients on high-dose statin therapy and there was no progression of atherosclerosis in this group, according to ultrasound testing.

In contrast, the volume of plaque buildup increased by nearly 3% during treatment among those taking the lower-dose therapy.

"Overall, these findings provide strong evidence that intensive treatment using the maximum approved dose of [Lipitor] reduces progression of atherosclerosis compared with a more moderate regimen consisting of 40 mg of [Pravachol]," write author Steven E. Nissen, MD, of The Cleveland Clinic, and colleagues.

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