Study Suggests Statins Could Help Some With Normal Cholesterol

These people have elevated levels of high sensitivity C-reactive protein, researchers say

WEDNESDAY, Aug. 25, 2010 (HealthDay News) -- Cholesterol-lowering statins could go a long way toward protecting against heart disease among patients who are deemed to have an "intermediate risk" for cardiovascular trouble, a new study suggests.

The finding specifically applies to those men and women who, despite having normal cholesterol levels, have high levels of a protein linked to inflammation (the so-called high sensitivity C-reactive protein, or "hsCRP"), and bear a 5 percent to 20 percent risk for developing heart disease within 10 years.

For such individuals, a regimen of statins could lower their risk for stroke and/or heart attack by more than 40 percent, the research indicates.

Study author Dr. Paul Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital in Boston, reports his team's observations in the Aug. 24 issue of Circulation: Cardiovascular Quality and Outcomes.

The American Heart Association and the U.S. Centers for Disease Control and Prevention both recommend hsCRP testing for patients with an intermediate risk for heart disease.

Statin drugs can be effective at lowering hsCRP levels as well as cholesterol, the study authors noted.

To arrive at their assessment, Ridker and his colleagues re-analyzed already-collected data from a large statin study that included men over the age of 50 and women over the age of 60 who were prescribed rosuvastatin (Crestor) at a dosage of 20 milligrams.

Using standard measures for assessing risk based on factors such as age, gender, smoking, blood pressure and cholesterol levels, the study authors determined that statins cause heart disease risk to drop by 45 percent among patients with a 10-year risk of between 5 percent and 10 percent, which tends to include more women than men.

Those facing an even higher decade-long risk (between 11 percent and 20 percent) saw that risk drop by nearly 50 percent, the study authors said.

Those with a less than 5 percent risk for heart disease did not seem to benefit from statin use, however.

Dr. Donald Smith, director of lipids and metabolism at the Cardiovascular Institute at Mount Sinai Medical Center in New York City, said the findings could lead to a significant shift in screening protocols for some groups.

"This potentially could change guidelines as to how you screen and treat those men and women in this particular age population, which is over the age of 50 in men and 60 in women. So, this does not apply to the whole population, and that's important to point out."

"But in this age group, among people with moderate risk for heart disease, getting a C-reactive protein screening just to see what's going on could be very helpful," Smith added. "Because this study shows that if that level is high -- even if their LDL is still very low -- they can benefit from statins."

Dr. Pamela Ouyang, a professor of medicine at Johns Hopkins University School of Medicine, cautioned that no conclusions should be drawn regarding other types of statins, or prescription regimens using dosages lower than those used in the study.

Still, she said in an American Heart Association news release that the "study provides important information indicating the groups of men and women who have high CRP and normal LDL cholesterol that could benefit from statin treatment."

Ridker is a co-inventor on patents held by the Brigham and Women's Hospital related to the use of inflammatory biomarkers in cardiovascular disease that have been licensed to the drug companies Siemens and AstraZeneca, according to the news release.

More information

To learn more about statins, visit the U.S. National Library of Medicine.

SOURCES: American Heart Association, news release, Aug. 24, 2010; Donald Smith, M.D., MPH, director, lipids and metabolism, Cardiovascular Institute, Mount Sinai Medical Center, New York City
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