Is High-Dose Lipitor Best for Heart Patients?
Cholesterol Study Shows Very Low LDL With Lipitor Cuts Heart Disease
March 8, 2005 (Orlando, Fla.) -- More apparently is better when it comes to lowering cholesterol.
A new study shows that when cholesterol was lowered to very low levels with high doses of Lipitor, people were much less likely to suffer another heart attack or stroke.
The Lower the Better
The study enrolled 10,000 patients who had heart disease. The participants had already lowered their LDL "bad" cholesterol level to less than 130 mg/dL before the start of the study.
All of the patients in the study started with LDL levels "that would have been considered extraordinarily low a few years ago," explains John C. LaRosa, MD, from the State University of New York in Brooklyn.
But in recent years doctors have learned that an LDL cholesterol level of less than 100 for people with heart disease is even better for warding off more heart problems. Roughly half of the patients were given 80 mg of Lipitor and half were given 10 mg Lipitor.
Cardiologists used high doses of Lipitor to achieve extremely low LDL levels, says LaRosa.
After five years of high-dose Lipitor, the average LDL had fallen to 77 mg/dL compared with 101 mg/dl in the low-dose Lipitor group.
The high-dose patients were 22% less likely to have a heart attack, stroke, or suffer from sudden deaths than the low-dose group, LaRosa says.
His results were presented at the American College of Cardiology meeting here and were also published online by the New England Journal of Medicine. The study was funded by Pfizer, which makes Lipitor.
Sidney Smith MD, director of the Center for Cardiovascular Science and Medicine at the University of North Carolina in Chapel Hill, tells WebMD there was virtually no downside to the high-dose treatment.
No significant side effects were reported such as increase in muscle pain, liver, or kidney problems. There were essentially no side effects and very positive benefits, Smith says.
LaRosa tells WebMD, "There are very few who don't respond to the drug," which suggests that the high-dose treatment could be widely used.
Achieving a lower LDL is clearly beneficial in patients who have a history of heart disease or have numerous heart disease risk factors, including high cholesterol, smoking, and high blood pressure which greatly increase the risk of future heart attacks.
LaRosa sums up by saying, "we have entered a new era in the treatment of established [heart] disease."