Millions More Seniors Could Benefit from Taking
Statins to Prevent Heart Attacks, Strokes
About 33 million older people - men 50 or older and
women 60 or older - are currently eligible to take statins
March 19, 2009 As many as 6.5 million more
older patients could benefit from taking statins, drugs typically used to
prevent heart attacks and strokes, than current prescribing guidelines
suggest, Johns Hopkins doctors report in a new study in the Journal
of the American College of Cardiology.
Doctors have long known that statins can help
prevent subsequent heart attacks and strokes in patients who have
already had one of these cardiovascular events.
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about recent study showing a cholesterol lowering drug - Crestor - cut
the risk of heart attack and stroke, even in people with normal
cholesterol.
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Additionally, statins have been shown to have a
protective effect for patients who haven't yet had a heart attack or
stroke but are at high risk for developing cardiovascular disease.
Consequently, doctors currently prescribe these
drugs both to patients with established cardiovascular disease, as well
as those with high cholesterol and other risk factors for developing
cardiovascular disease such as diabetes.
About 33 million older adults men age 50 or older
and women age 60 or older are currently eligible to take statins based
on these criteria.
About half of all cardiovascular events occur in
patients who don't have high cholesterol, and about 20 percent of these
events occur in people who have no identifiable cardiovascular disease
risk factor, according to Erin D. Michos, M.D., M.H.S., assistant
professor of medicine at the Johns Hopkins University School of Medicine
and its Heart and Vascular Institute.
Until recently, doctors haven't been sure if any of
these patients might also benefit from statin therapy.
Last November, a research team led by doctors at
Brigham and Women's Hospital in Boston announced the results of a study
known as the JUPITER trial that involved nearly 18,000 patients. They
found that statins protect against heart attacks and strokes even in
older adults without known cardiovascular disease or diabetes and with
low cholesterol, below 130 mg/dl - a group that isn't usually prescribed statins - as long as these patients also had high levels of C-reactive
protein (CRP), a blood marker for inflammation.
Recent research has shown that inflammation plays
an important role in initiating cardiovascular events, says Michos, but
at-risk patients aren't routinely tested for CRP levels.
Building on the JUPITER trial results, Michos and
Hopkins cardiology professor Roger S. Blumenthal, M.D., wondered how
many patients in the United States fit the low-cholesterol, high-CRP
profile featured in the study and might also benefit from taking statins.
To get an estimate, they gathered data generated by
the National Health and Nutrition Examination Survey, or NHANES. This
research program, which has gathered various health data from thousands
of Americans from 1971 to the present, weights the data from its
participants so that they're representative of the entire United States
population.
After searching NHANES between the years 1999 and
2004 for participants that fit the JUPITER profile, then extrapolating
that to the general population, Michos and Blumenthal estimate that
about 6.5 million older adults with low cholesterol and high CRP might
benefit from statins.
If they expanded their search criteria to the
cholesterol level cutoff of 160 mg/dl that doctors often use when
deciding to prescribe statins, the researchers increased this statin-benefiting
group's size to 10 million.
"We're showing that doctors may be able to prevent
thousands of heart attacks, strokes and deaths each year if we expand
statin-prescribing criteria to include C-reactive protein levels,
something we can assess as part of a simple blood test," says Michos.
The team points out in the study, published in the
March 17 issue of the Journal of the American College of Cardiology,
that based on JUPITER's results, prescribing statins to older adults
using this new criteria that incorporates CRP would prevent about
260,000 cardiovascular events over five years.
Keep up with the latest news for senior citizens, baby
boomers
March 19, 2009 As many as 6.5 million more
older patients could benefit from taking statins, drugs typically used to
prevent heart attacks and strokes, than current prescribing guidelines
suggest, Johns Hopkins doctors report in a new study in the Journal
of the American College of Cardiology.