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Cholesterol-lowering
statins should be prescribed to a wider circle of people who
are at risk of having a heart attack or stroke, according
to a study reported in the July 6th issue of the Lancet.
Statins
are usually only given to people who have heart disease and
raised blood cholesterol, but researchers at the University
of Oxford have found that the drugs have substantial benefits
for high-risk patients considered to have normal or low cholesterol.
The researchers
said their findings should be definitive enough to prompt
a change in the current guidelines on statins so that they
are considered for anybody at increased risk of heart attack
or stroke, regardless of cholesterol level.
The study
consisted of over 20,000 patients between the ages of 40 and
80 who had either coronary or other occlusive arterial disease
or diabetes. The participants were given daily doses of statins
or a placebo for five years.
The researchers
found that those taking statins had lower risk of dying from
all causes than those taking the placebo (14.7 percent to
12.9 percent), mainly due to an 18 percent reduction in the
coronary death rate in the statin group.
Those
taking statins also reduced their risk of a non-fatal hear
attack or coronary death, non-fatal or fatal stroke and coronary
or non-coronary revascularization by 25 percent. No major
side effects were reported.
Lead researcher
Dr. Rory Collins, of the University of Oxford's clinical trial
services unit, said the study shows "unequivocally that
statins can produce substantial benefits in a very much wider
range of high-risk people than had been previously thought."
Lancet
Editor Richard Horton called the findings the most important
and far-reaching for the treatment and prevention of heart
disease and stroke seen in a generation. "These findings
should tear up the rulebook on statin prescribing," he
said. "They should result in a dramatic change in clinical
practice around the world."
Source:
Medical Week staff,
week of June 30, 2002
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