Anti-cholesterol statin drugs may be over-prescribed: study

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Tuesday 16 November 2010 20:00 EST
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(Mike Flippo)

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Cholesterol-lowering statin medications, miracle drugs for those suffering from heart disease, may be over-prescribed as a preventative measure for healthy adults, a new study said Tuesday.

The study by cardiologists at Johns Hopkins University found that, among healthy adults, only those with measurable buildup of artery-hardening calcium would significantly benefit from the treatment.

"Our results tell us that only those with calcium buildup in their arteries have a clear benefit from statin therapy," the study's lead investigator Michael Blaha said in a statement.

"Those who are otherwise healthy and have no significant calcification should, with their physician, focus on aggressive lifestyle improvements instead of early initiation of statin medications," he added.

The statin class of pharmaceuticals, including the popular cholesterol-lowering drugs Lipitor and Crestor, lowers cholesterol by blocking an enzyme in the liver.

The six-year study found that 75 percent of all heart attacks, strokes or heart-related deaths occurred in the 25 percent of participants who had the highest calcium buildup in their blood vessels.

The 47 percent of participants who had no detectable levels of calcium buildup meanwhile suffered just five percent of heart disease-related events, meaning the statin therapy would have offered little protection.

"It certainly is not the case that all adults should be taking (statin therapy) to prevent heart attack and stroke, because half are at negligible risk of a sudden coronary event in the next five to 10 years," Blaha said.

Roger Blumenthal, another Johns Hopkins researcher who carried out the study, said the drugs "should not be approached like diet and exercise as a broadly based solution for preventing coronary heart disease."

"These are lifelong medications with potential, although rare, side effects, and physicians should only consider their use for those patients at greatest risk, especially those with high coronary calcium scores."

He added that as many as five percent of people on statins develop serious side effects, such as muscle pain, while one in 255 will develop diabetes.

The study of 950 healthy and ethnically diverse men and women was unveiled on Tuesday at an American Heart Association conference in Chicago.

The report is the latest in a series of studies questioning the widespread prescription of preventative heart medication for otherwise healthy adults.

A US meta-analysis of 11 studies published in June had already revealed that statin treatments do not reduce the death rate among patients with high cholesterol but no history of heart disease.

The two studies contrast the results of a 2008 clinical trial known as "JUPITER," which found that a daily does of 20 milligrams of Crestor, a statin treatment marketed by the British pharmaceutical giant AstraZeneca, halved the number of potentially fatal coronary blockages in 18,000 adults.

All of the adults in the JUPITER study had high levels of C-reactive protein (CRP), believed by some to predict coronary disease.

But Blaha said the latest study underscores the view that calcium deposits are a better indicator than CRP, which he said offered no predictive value.

Coronary heart disease remains the leading cause of death in the United States, responsible for one in five deaths among adults.

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