Cholesterol-lowering statins do save lives: US study

A real-world study of more than half a million Americans has ¬underlined the benefits of cholesterol-lowering statins, finding the drugs save lives — and the more potent the drugs, the better.

The Stanford University-led study of 510,000 people suffering hardened arteries found that those on high-intensity statins were 17 per cent less likely to die in a given year than patients taking moderate-dose drugs, and 40 per cent less likely than those receiving no statins at all.

The study, published in the journal JAMA Cardiology, could end a stand-off over whether high or medium-strength pills are preferable. The findings also damn claims in a controversial 2013 episode of Catalyst science program, which helped trigger ABC management’s decision last week to scale back the program.

The one-sided documentary, watched by a reported 1.5 million Australians, highlighted the side effects of statins and questioned their effectiveness. A Sydney University study subsequently estimated that up to 2900 “major vascular events” would result from heart patients ditching their statins after watching the program.

Statins, which are among the world’s most used drugs, have long courted claims that they are over-prescribed, provide limited benefit and trigger muscle pain and diabetes. An Oxford University review this year found that the side-effects had been overstated and the benefits downplayed.

That study concluded that for every 10,000 patients who took statins for five years, 1500 people would avoid cardiovascular events such as heart attacks or strokes, while 200 at the most would experience side-effects – most of them reversible.

The new study tracked cardiovascular patients taking different doses of statins, and tallied their fatalities over 12 months. Four per cent of those receiving high-intensity statins died, compared to 4.8 per cent of people on moderate doses, 5.7 per cent on low doses and 6.6 of those receiving no statins.

The American Heart Association recommends high-intensity statins for adults with established heart disease. But the country’s Veterans Health Administration recommends only moderate doses, claiming clinical trials have not shown sufficient benefit from high-concentration drugs. The sheer statistical power of the new study demonstrates the benefit, the researchers say.

Australian guidelines take a different tack, recommending whatever dose is necessary to bring cholesterol levels down to a target range. Garry Jennings, chief medical advisor to the National Heart Foundation, said the new findings were consistent with an “emerging consensus” that high-intensity statins were preferable.

Tom Marwick, director of the Baker IDI Heart and Diabetes Institute in Melbourne, said he was attracted to the approach suggested by the new study. “It’s all very well having targets, but risk is a continuum,” he said.

“There’s no cliff that you suddenly fall over – you want to drive risk down as much as you can.”

But Professor Marwick said the most important thing was not to get patients to take high doses, but to convince them to take their statins in the first place.