We have a report tonight on three important stories concerning treatments for people at high risk for heart disease and stroke. Taken together, those conditions kill more than 830,000 Americans a year -- far more than anything else -- so it is important to know what works and what doesn't to lower the risk.
One study is part of a trend. Scientists have been finding that lowering blood cholesterol further and further is amazingly effective at combating the disease. In this latest study, researchers managed to get 500 people who had already suffered heart disease to take high doses of one of the cholesterol lowering drugs called statins -- in this case Crestor, made by Astra Zeneca. The average level of LDL, the so called "bad cholesterol," dropped from 130 to 60 in the study, an unheard of drop. Using a technique that measures artery-clogging plague inside the blood vessels, the researchers found that after two years the amount of plaque receded by up to nine percent. In other words, the heart disease seemed to reverse.
It is important to note that this study was not large enough or long enough to measure an actual drop in heart attacks or strokes -– and that research needs to be done. But the evidence strongly suggests that when the plaque goes away, the risk for cardiovascular disease will recede.
It is also important to note that this study is yet another endorsement of statin drugs, which already are the best selling medications in history. Exercise and a heart healthy diet remain the major weapons against heart disease. Many people will never needs statins. But very few Americans who do need them can get their cholesterol down to the levels that are now recommended without these drugs, and they can be very expensive. But remember, statins come in several brands and some of the older ones are now off patent and thus much cheaper. Everyone who needs a statin does not need the latest and most expensive ones. It would make sense for everyone who needs a statin to start on a older one and go to the newer more expensive brands only if they are not hitting their goals. That is a serious discussion to have with your doctor, especially if you pay for all or part of your medications.
Another point worth mentioning again: the statin used in this study is Crestor, made by Astra Zeneca. Some consumer groups, especially Public Citizen, have said that Crestor has an unacceptably high rate of a side effect shared with all statins: a muscle weakening called rabdomyolosis. The company denies the problem and so far the FDA agrees. But, again, you do not need to take Crestor or another specific statin to get a significant drop in your bad cholesterol.
There are also two negative studies to report on people at high risk for heart disease. On the basis of preliminary evidence, many doctors widely prescribed Plavix, a blood thinner to be taken along with aspirin to lower the risk of heart attacks. A major advertising campaign helped push Plavix sales to $3.5 billion a year. But finally, a big study actually tested the idea and found that Plavix, which costs about $4 a day, was no better than a daily aspirin, which costs pennies.
The other negative study showed that people taking vitamins B6, B12 and folic supplements had no less heart disease. Some scientists had hoped the supplements would reduce disease risk because they reduce the level of a natural body chemical called homcysteine. Studies of large groups of people found that those with high levels of homcysteine, like those with high levels of bad cholesterol, have more heart disease and stroke. But the vitamins did nothing to reduce the risk.