Patients with high cholesterol levels who continually take statins appear to have a lower risk of death over four to five years, regardless of whether they already have diagnosed heart disease, according to a report in the February 9 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Statin drugs have been shown to have a beneficial effect on levels of low-density lipoprotein (LDL, or “bad”) cholesterol, according to background information in the article. The benefits of these medications have been demonstrated in clinical trials for secondary prevention (controlling risk factors and preventing death in patients who already have heart disease). However, some have questioned the effectiveness of statins for preventing deaths in patients taking them for primary prevention (delaying or preventing the development of heart disease).
Varda Shalev, M.D., and colleagues at Maccabi Healthcare Services and Sackler Faculty of Medicine, Tel Aviv,
During the study, 4,259 patients in the primary prevention group and 8,906 in the secondary prevention group died. In both groups, continuity of taking statins—defined as taking statins for at least 90 percent of the follow-up period—conferred at least a 45 percent reduction in the risk of death compared with patients who took statins less than 10 percent of the time. The risk reduction was stronger among patients with high levels of LDL cholesterol at the beginning of the study and among patients whose initial treatment was with high-efficacy statins.
“In conclusion, this study showed that the continuation of statin treatment provided an ongoing reduction in all-cause mortality [death] for up to 9.5 years among patients with and without a history of coronary heart disease,” they continue. “The observed benefits from statins were greater than expected from randomized clinical trials, emphasizing the importance of promoting statin therapy and increasing its continuation over time for both primary and secondary prevention.”
Arch Intern Med. 2009;169:260-268.