Pop a Heart Disease Prevention Pill?

Heart

Many people who have above normal cholesterol numbers or blood pressure readings are reluctant to take prescription drugs going forward. The numbers have to be higher – and bode poorly for the future – for many to admit they might need pharmacological help maintaining their cardiovascular health. So news that research shows that even those at less of a risk for heart disease should pop statin pills as a prevention tool may be met with hesitation, especially since the medications do have side effects.

Heart disease causes approximately 50 million heart attacks and strokes and 18 million deaths every year and about globally every year. That is in spite of the considerable amount of statins and other prescription drugs consumed worldwide. Would expanding the number of people taking cholesterol-lowering drugs and other heart meds save more lives? That was the underlying question for new research from McMaster University’s Population Health Research Institute (PHRI) and Hamilton Health Sciences.

Adults with high blood pressure readings and a solid risk of cardiovascular disease can reduce their long-term risk of having a heart attack or stroke almost in half by taking a prescription cocktail of medication for reducing their blood pressure along a cholesterol fighting statin. That has been regular medical protocol for some time. But, new global research effort, called Hope-3, could result in people with less of an apparent risk taking cholesterol-reducing statins even if they do not have clear indications of heart problems.

The results of the research, which was partly funding by AstraZeneca, a manufacturer some of the medications used, as well as the Canadian Institutes of Research and Health, were presented Saturday at the annual American College of Cardiology and were published in the New England Journal of Medicine. The findings could potentially change guidelines on which patients should consider taking the medications.

The researchers examined data on medications used by over 12,000 participants from 21 countries to evaluate means of preventing cardiovascular disease. Most previous heart disease prevention research has used white patients from North America who had higher risks because of unhealthy cholesterol levels, high blood pressure, or other conditions. Because of the global reach, only one-fifth included in the new research were white. The study used patients at moderate risk because of their age (over 55 for men and 60 for women) and at least one other risk factor, such as a family history, obesity or smoking. For most, their cholesterol levels were close to normal and their blood pressure readings were just below the 140 over 90 level, which is considered to be the borderline for a high-blood pressure diagnosis.

The study participants were randomly assigned for almost six years to three treatment regimens (a statin, blood pressure medication or both) in low doses or a fourth group receiving placebos.  Those receiving the drug treatments (as opposed to the placebos) did have reduced cholesterol and blood pressure levels but the research’s other results varied. The statin-only participants were 25 percent less likely to have heart disease than those on placebos and the people taking both drugs fared a little better. So the statins clearly had a positive impact. The blood pressure medication, however, had no discernible improvement (the dose was lower than typically taken by those known to have problems).

The statins did not give good news overall, though. Those patients experienced more side effects, such as muscle pain, muscle weakness and cataract problems than those not taking them. Clearly more research on different doses is needed to determine if it make sense to pop a heart disease pill as a prevention measure.

Written and Edited by Dyanne Weiss

Sources:
McMaster University: Researchers find ‘simple’ methods to prevent heart attacks and stroke worldwide
Forbes: More People Should Consider Cholesterol Pills, Study Says
Reuters: Statin, blood pressure drug slash health risk in those with hypertension
Boston Herald: Global research sees statin results in lower risk patients

Photo by Администрация Волгоградской области – used under Creative Commons license

Your Thoughts?