Got a Bad Heart – Stick to Statins!

A new study by Dutch researchers has found that people with high cholesterol levels are at 30% higher risk of heart attacks if they stop taking their statin drugs. The study comes in the wake of concerns over lot of potential heart patients stopping statin treatment.

Statins are generally prescribed to individuals at risk of coronary heart disease to bring a reduction in their cholesterol levels. Perhaps the most extensively prescribed medicines at present, statins are used by billions across the world.

60,000 people were covered under the study and followed for well over two years. It was found that more than half of the subjects covered gave up on statins within two years while only one-third remained persistent users and stuck to a high or intermediate dose. The researchers found that among patients who persistently used statins, hospital admissions for heart attacks dropped by 30%.

“That finding is entirely understandable,” said Ron Herings, Director of the PHARMO Institute in Amsterdam, and an author of the report. “You have a high risk when you start using these drugs,” Herings said. “When you stop, your risk increases to baseline, and that is a 30% to 40% increase.”

The study showed reduction in risk is directly related to the patients’ persistency in taking a statin as well as the dosage. For example, hospital admissions dropped from 0.52 per 100 patient years to 0.42 per 100 patient years among patients who took the drugs on a non-regular basis. On the other hand, risk reduction was as high as 40% among high or intermediate dose users while it was only 20% among those using a low dose.

“The findings support the recently adopted view that intensive statin therapy pays benefits,” said Dr. Stephen Nicholls, a cardiologist who is Director of the Intravascular Ultrasound Laboratory at the Cleveland Clinic. “We need intensive therapy to get LDL cholesterol levels as low as possible,” Dr. Nicholls said. LDL cholesterol is the bad kind that clogs arteries.

But according to Dr. Nicholls, the study also brings to light a continuing problem in achieving that goal. “Despite the fact that we have a large body of evidence that taking statins lowers LDL levels and is beneficial, in the real world, there seems to be a discord in getting this into clinical practice,” he said.

“One reason people stop taking statins is that they feel no immediate improvement,” Herings said. “You do not find a benefit if your lipids are controlled,” he said. “Also, it is difficult to take a drug for many years, especially when you have to take many drugs. Another factor is a widespread fear of adverse side effects. Even a mild drug reaction can make patients stop,” he added.

“That fear goes against the clinical evidence indicating that statins are the most rigorously tested class of drugs in terms of the number of patients enrolled in clinical trials,” Dr. Nicholls said. “Those trials show statins are tolerated by the overwhelming majority of patients with no problems at all,” he added. “As the Dutch study shows, statins will remain an integral part of any strategy to reduce heart disease,” Dr. Nicholls concluded.

The study findings are published in the latest online edition of the European Heart Journal.

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