Intensive Statin Therapy Stops Plaque Buildup
Higher Doses of Cholesterol-Lowering Drugs Fight Atherosclerosis Better
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
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.