Statins for everyone!!
 

http://news.yahoo.com/s/ap/20081109...TmQwY8x5Xda24cA



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Study: Wider cholesterol drug use may save lives
By MARILYNN MARCHIONE, AP Medical Writer Marilynn Marchione, Ap Medical Writer 43 mins ago

NEW ORLEANS – People with low cholesterol and no big risk for heart disease dramatically lowered their chances of dying or having a heart attack if they took the cholesterol pill Crestor, a large study found.

The results, reported Sunday at an American Heart Association conference, were hailed as a watershed event in heart disease prevention. Doctors said the study might lead as many as 7 million more Americans to consider taking cholesterol-lowering statin drugs, sold as Crestor, Lipitor, Zocor or in generic form.

"This takes prevention to a whole new level, because it applies to patients who we now wouldn't have any evidence to treat," said Dr. W. Douglas Weaver, a Detroit cardiologist and president of the American College of Cardiology.

The study also gives the best evidence yet for using a new test to identify people who may need treatment, according to a statement from Dr. Elizabeth Nabel, director of the National Heart, Lung and Blood Institute. The new research will be considered by experts reviewing current guidelines.

However, some doctors urged caution. Crestor gave clear benefit in the study, but so few heart attacks and deaths occurred among these low-risk people that treating everyone like them in the United States could cost up to $9 billion a year — "a difficult sell," one expert said.

About 120 people would have to take Crestor for two years to prevent a single heart attack, stroke or death, said Stanford University cardiologist Dr. Mark Hlatky. He wrote an editorial accompanying the study published online by the New England Journal of Medicine.

"Everybody likes the idea of prevention. We need to slow down and ask how many people are we going to be treating with drugs for the rest of their lives to prevent heart disease, versus a lot of other things we're not doing" to improve health, Hlatky said.

Statins are the world's top-selling drugs. Until this study, all but Crestor have already been shown to cut the risk of heart attacks and death in people with high LDL, or bad cholesterol.

But half of all heart attacks occur in people with normal or low cholesterol, so doctors have been testing other ways to predict who is at risk.

One is high-sensitivity C-reactive protein, or CRP for short. It is a measure of inflammation, which can mean clogged arteries as well as less serious problems, such as an infection or injury. Doctors check CRP with a blood test that costs about $80 to have done.

A co-inventor on a patent of the test, Dr. Paul Ridker of Harvard-affiliated Brigham and Women's Hospital in Boston, led the new study. It involved 17,802 people with high CRP and low LDL cholesterol (below 130) in the U.S. and 25 other countries.

One-fourth were black or Hispanic, and 40 percent were women — important because previous statin studies have included few women. Men had to be 50 or older; women, 60 or older. None had a history of heart problems or diabetes.

They were randomly assigned to take dummy pills or Crestor, the strongest statin on the market, made by British-based AstraZeneca PLC. Neither participants nor their doctors knew who was taking what.

The study was supposed to last five years but was stopped in March, after about two years, when independent monitors saw that those taking Crestor were faring better than the others.

Full results were announced Sunday. Crestor reduced a combined measure — heart attacks, strokes, heart-related deaths or hospitalizations, or the need for an artery-opening procedure — by 44 percent.

"We reduced the risk of a heart attack by 54 percent, the risk of a stroke by 48 percent and the chance of needing bypass surgery or angioplasty by 46 percent," Ridker said.

Looked at another way, there were 136 heart-related problems per year for every 10,000 people taking dummy pills versus 77 for those on Crestor.

Remarkably, every single subgroup benefited from the drug.

"If you're skinny it worked, if you're heavy it worked. If you lived here or there, if you smoked, it worked," Ridker said.

AstraZeneca paid for the study, and Ridker and other authors have consulted for the company and other statin makers.

One concern: More people in the Crestor group saw blood-sugar levels rise or were newly diagnosed with diabetes.

Crestor also has the highest rate among statins of a rare but serious muscle problem, so there are probably safer and cheaper ways to get the same benefits, said Dr. Sidney Wolfe of the consumer group Public Citizen.

"It is highly unlikely that (the benefits are) specific to Crestor," said Wolfe, who has campaigned against the drug in the past.

Crestor costs $3.45 a day versus less than a dollar for generic drugs.

Drs. James Stein and Jon Keevil of the University of Wisconsin-Madison used federal health statistics to project that 7.4 million Americans, or more than 4 percent of the adult population, are like the people in this study.

Treating them all with Crestor would cost $9 billion a year and prevent about 30,000 heart attacks, strokes or deaths, they calculate.

"That's pretty costly. This would be a very difficult sell" unless a person also had family history or other heart disease risk factors, said Dr. Thomas Pearson of the University of Rochester School of Medicine and Dentistry.

Pearson was co-chairman of a joint government-heart association panel that wrote current guidelines for using CRP tests to guide treatment.

Researchers do not know whether the benefits seen in the study were due to reducing CRP or cholesterol, since Crestor did both.

This study and two other government-sponsored ones reported on Sunday "provide the strongest evidence to date" for testing C-reactive protein, and adding it to traditional risk measures could identify millions more people who would benefit from treatment, Nabel's statement says.

U.S. Crestor prescriptions totaled $420 million in the third quarter of this year, up 23 percent from a year earlier. In the rest of the world, third quarter sales were $520 million, up 33 percent.

Sales have been rising even though two statins — Zocor and Pravachol — are now available in generic form.

___

On the Net:

New England Journal: http://www.nejm.org

Heart conference: http://www.americanheart.org

Government: http://www.nhlbi.nih.gov/health/dci...CAD_WhatIs.html

Copyright © 2008 The Associated Press. All rights reserved. The information contained in the AP News report may not be published, broadcast, rewritten or redistributed without the prior written authority of The Associated Press.
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I don't suppose it could be because cholesterol isn't the issue? :help:

I won't be taking them!!!

:idea: Well, maybe statins don't work by lowering cholesterol and also cholesterol might not cause heart disease ...

Great idea, stop the study after 2 years before the cancer deaths show up.

My mind is always open, but I have stopped taking statins after some sort of serious side effects/infection which is most likely statin poisoning.

Other studies like this have found heart attacks reduced, but not total mortality.

It is also likely that maybe 25% of those using statins will suffer side effects, and some of them serious, and for some not reversable.

Another possibility, referred to earlier, that the good statins do may not be directly related to lowering cholesterol, but by some other mechanism. If that is so very low doses of statins may provide the same benefit but without side effects. My side effects appeared after doctor doubled statin dosage to help with triglycerides (which statins don't help, or so I have read).

A reason that statins may help is because the normal LDL cholesterol test is hugely inaccurate. If you have small LDL it is underreported in the Friedewald calculation and that is the sort that is very damaging. If you have large LDL it is overreported and since large LDL is harmless statins aren't going to help.

A couple of articles about that:
http://heartscanblog.blogspot.com/search?q=friedewald

Oh don't worry about the CAUSE of the inflammation, here's a pill. Are we seriously planning on giving people something so scary as statins as a PREVENTATIVE measure now. I'd prescribe them as last resort. Out of control isn't it?

Statin proponents claim that statins lowers the risk of heart disease. They never claim that statins lower the incidence of heart disease, which they haven't. However, even to claim the lowering of risk is self-serving because statin proponents define risk as total LDL, an erroneous definition of heart disease risk.

Yeah, the study was just on the nightly news-- they said you mainly need to check [worry about] your CRP.

Well, my LDL is over 135 but my CRP is "essentially zero" fancy that :)

Another "healthy" push for cholesterol-lowering medication
 

http://www.reuters.com/article/mark...939180520081109

Everybody loves Crestor.

Here's a lovely side effect....

Is there an actual difference between CRP and hsCRP and did the study makers know what was causing the increased CRP in the first place. Was it inflammation in the arteries, or an outbreak of arthritis, or acne, or having a cold? All these can raise CRP. Why didn't they go for finding a way to reduce the inflammation in the first place rather than masking the symptoms.

Because that would obviate the need for more drug sales.

Mmmm profit motive.

--Melissa

J-lo, they are already doing that. Now they can use this study to justify prescribing statins to a larger group of people as a preventative measure, even though no one has shown that they prevent anything.

I remain amazed that these drugs are prescribed around the world to so many people. I am further amazed by people who will take them, knowing they can do no good at all, because they are afraid their doctors will refuse to treat them if they refuse to take statins.

I've watched researchers in my field take huge leaps of reasoning without realizing what they are doing and seen where that huge leap bit them in the butt. Statins affect heart disease is a huge leap of reasoning.

But, I could have sworn that there have been other papers showing that it is likely the reason statins have any effect is because of their anti-inflammatory properties. In fact, I thought that was in Taubes book. Which leads me to wonder why anyone would prescribe a statin when aspirin is dirt cheap.