Giving high doses of statins to patients with heart disease doesn’t lower the risk of future heart trouble any more than moderate doses of the cholesterol-lowing drugs do, a new study finds.
Having heart disease raises the risk of heart attack and stroke, as blood vessels become clogged and cut the normal flow of blood and oxygen to the heart. These patients are typically prescribed statins on a long-term basis, to lower levels of vessel-clogging LDL (“bad”) cholesterol. But experts remain conflicted about exactly how low LDL cholesterol levels should go.
“Our study demonstrates that physicians treating patients with heart disease and elevated levels of cholesterol with statins have to ensure that patients meet a target of less than 100 mg/dL to prevent further [heart] events,” said study author Dr. Morton Lelbowitz. He is a senior physician with the Clalit Research Institute in Tel Aviv, Israel.
According to the U.S. Food and Drug Administration (FDA), millions of Americans currently take statins, including well-known brands such as Crestor (rosuvastatin), Lipitor (atorvastatin), and Zocor (simvastatin), among others. But the FDA also stresses that the heart benefits of lowering cholesterol levels with statins is “indisputable.” What is in dispute is what the ideal target cholesterol level should be.
For example, while the American Heart Association does not advocate for any specific LDL target level, the European Society of Cardiology recommends that LDL be brought down to a relatively “low” level of 69 mg/dL or less.
To examine the issue, investigators tracked more than 31,600 patients, ranging in age from 30 to 84, all of whom had been diagnosed with heart disease between 2009 and the end of 2013. All had been taking statins for at least one year.
Nearly 30% were found to have “low” LDL levels, meaning a reading of 70mg/dL or less. More than half had a “moderate” LDL level of between 70.1 and 100mg/dL, while nearly 20% had “high” levels exceeding 100 and as high as 130.
Patients were followed for an average of 1.6 years, and during that time more than 9,000 either died or faced a serious cardiac event, including heart attack, stroke, chest pain (angina), heart bypass surgery or surgery to unblock arteries (angioplasty).
The researchers determined that the risk for such events was significantly lower among patients with moderate LDL levels, compared to patients with high LDL levels.
However, driving LDL levels down into the 70mg/dL range did not translate into any further drop in risk, the study found.
The findings were published in the June 20 online edition of JAMA Internal Medicine.
I would dispute the FDA’s contention that lowering cholesterol with statins provides heart benefits. The benefit of taking statins is from the reduction of artery inflammation, not from reducing the LDL. Artery inflammation is what drives the body to link homocysteine to LDL cholesterol, creating a “patch” over the inflamed artery wall. This is actually a repair process when it occurs in moderation. However, excessive inflammation creates plaque formation that occludes the vessel resulting in cardiovascular disease. The reduction in LDL cholesterol is merely a side effect of statin drugs.
Please note that this study looked at patients previously diagnosed with heart disease. However, a large percentage of Americans taking statin drugs have no history of heart disease, they just had a total cholesterol over 200. Most of these patients have had no laboratory testing to measure artery inflammation. Furthermore, previous studies have shown that 10% of patients taking statin drugs develop cardiac myopathy (heart muscle disease).
The Bottom Line:
It is way past the time for the medical profession to admit their theory on lowering cholesterol and LDL cholesterol to prevent heart disease is a myth. Tell the public you were wrong but got lucky because statin drugs do reduce artery inflammation. Of course there are far better ways of reducing artery inflammation and Big Pharm doesn’t want you to know that.
Source: June 20, 2016 National Institutes of Health