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Senior Citizen Health & Medicine
Statin Drug Stops Atherosclerosis but Does Not
Reverse the Disease
Baby boomers with minimal plaque deposits were
tested
 March 26, 2007 – The statin drug rosuvastatin
reduced the progress of arterial thickening and stopped atherosclerotic
disease when tested on low-risk middle-aged baby boomers with no more
than mild or early stage cholesterol deposits (plaques) forming on the
inner surfaces of the arteries.
Atherosclerosis is the progressive thickening and
hardening of the walls of medium-sized and large arteries as a result of
fat deposits on their inner lining. Atherosclerosis is often advanced
before symptoms appear, and it is not clear whether treatment is
beneficial in middle-aged individuals with a low Framingham risk score
(a measure used to predict the risk of cardiovascular disease) and mild
to moderate atherosclerosis.
Lipid-lowering therapy has been shown to reduce
cardiovascular events in a large number of studies. Statin drugs as well
as other agents and lifestyle changes have also been shown to slow the
progression of and even regress atherosclerosis, according to background
information in the article.
John R. Crouse III, M.D., of the Wake Forest
University School of Medicine, Winston-Salem, N.C., and colleagues
conducted a randomized study of 984 individuals. The study results were
presented yesterday at the American College of Cardiology’s annual
conference and will appear in the March 28 issue of the Journal of the
American Medical Association.
The "Measuring Effects on Intima-Media Thickness:
an Evaluation of Rosuvastatin (METEOR)" study was designed to
investigate the effect of a 40-mg. dose of rosuvastatin on carotid
intima-media thickness (CIMT, a measure of the thickness of the middle
layers of the carotid arteries) over two years in middle-aged
individuals with low Framingham risk scores, but with evidence of
subclinical atherosclerosis.
“Rosuvastatin treatment was associated with a 49
percent reduction in LDL-C [“bad” cholesterol] level, a 34 percent
reduction in total cholesterol level, an eight percent increase in HDL-C
[“good” cholesterol] level, and a 16 percent reduction in level of
triglycerides,” the authors write.
“Compared with placebo, rosuvastatin significantly
slowed progression of the maximum CIMT for the 12 carotid sites,” they
continue, although the study did not demonstrate regression of disease
with rosuvastatin. The authors point out, “In contrast to the
significant progression of atherosclerosis in the placebo group, no
significant progression was observed in the rosuvastatin group.”
The 40-mg. dose of rosuvastatin was well tolerated
during the two-year study period and showed a similar safety profile to
that of placebo.
“In conclusion, the findings of METEOR demonstrate
that in middle-aged adults with Framingham risk scores lower than ten
percent and evidence of subclinical atherosclerosis, rosuvastatin
treatment resulted in statistically significant reductions in the rate
of progression of maximum CIMT during a two-year period compared with
placebo. Rosuvastatin did not induce regression overall,” the authors
conclude. “Larger, longer-duration randomized trials focused on clinical
events are needed to determine the practice implications of these
findings.”
Editorial: Primary prevention of atherosclerotic
cardiovascular disease
"The METEOR findings reflect a warning of problems
lurking ‘out there’ in the vast person-time space of the low-risk
population,” writes JAMA Contributing Editor Michael S. Lauer, M.D., of
the Cleveland Clinic Lerner College of Medicine at Case Western Reserve
University, Cleveland, in an editorial in the JAMA issue.
Lauer says even with this evidence, low-risk
individuals should not undergo routine arterial imaging followed by
statin therapy when evidence of asymptomatic disease is discovered.
“Ambitious event-based randomized trials involving
large numbers of patients and communities must be done. While these
trials will be difficult and expensive, even greater and less desirable
challenges will occur by choosing to ignore the enormous public burden
of clinical atherosclerosis arising from the population of low-risk
individuals,” he concludes.
Editor's Note: The METEOR study was funded by
AstraZeneca.
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