A new study suggests that just about everyone over the age of 50 should consider taking medications to reduce their cholesterol to cut their risk of stroke and heart attacks.
The huge study, published in The Lancet, finds that the medications, called statins, benefit even healthy people with no known heart problems.
The study, from researchers at Oxford University, found that statins safely reduce the risk of non-fatal heart attacks, strokes, and the need for angioplasty and other "revascularization" surgery by about a fifth in a wide range of individuals.
Though statins do carry the risk of side effects, such as elevated blood sugar, the researchers say that the benefits of widespread statin use would greatly outweigh those risks.
The researchers reviewed findings from 27 clinical trials involving 175,000 people who were randomized to take either statins or placebo pills. Most of the trials were supported by research grants from the pharmaceutical industry.
The participants were grouped into one of five groups based on their risk of having a major vascular event in the next five years.
The researchers found that statins reduced the risk of serious vascular events by 21 per cent in each of the 5 risk groups for each unit reduction (1 mmol/L) in their level of LDL cholesterol – the so-called "bad" cholesterol. The benefits were seen in both men and women, no matter what level of cholesterol they started out with.
In absolute numbers, cardiovascular events were reduced by 11 per 1,000 people over five years, for each 1 mmol/L reduction in LDL cholesterol
The researchers point out most statins can reduce LDL by much more than 1 mmol/L, so there could be even larger absolute reductions in strokes and heart events if statins were used more widely.
Even in those who were thought to have less than a 10 per cent chance of a heart attack or stroke, their already small risk was significantly lowered, mainly due to a drop in heart attacks rates and revascularization surgery rates.
There was no evidence from the studies that those taking statins had an increased risk of developing cancer or of dying from non-vascular causes. But there were small increased risks of a more rare type of stroke, called hemorrhagic strokes, and in diagnoses of diabetes.
"…But the definite benefits of statins greatly outweigh these potential hazards," the researchers wrote.
The study authors conclude that treatment guidelines about who should and shouldn't take statins "might need to be reconsidered."
An accompanying commentary by Drs. Shah Ebrahim and Juan P Casas from the London School of Hygiene and Tropical Medicine says that since most people over 50 are likely to be at higher risk of cardiovascular disease, it might be ‘pragmatic' to use that age of 50 as a guideline of when to prescribe statins, instead of doing costly medical tests.
The study was written by a group called the Cholesterol Treatment Trialists' (CTT) Collaborators. Some members of the team have been compensated to participate in scientific meetings from the pharmaceutical industry.
The study was funded by the British and Australian medical research councils and the British Heart Foundation.
