Only Half on Statins See 'Appropriate' Reduction in Bad Cholesterol

18 Avril, 2019, 11:37 | Auteur: Yves Courtet
  • Millions of patients around the world taking statins to lower the risk of heart disease fail to achieve the recommended levels of cholesterol reduction after two years of treatment. — AFP pic

Half of the patients - 84,609 in total - did not see their cholesterol go down by enough - the required 40% or more reduction specified by guidelines - even after being on the daily treatment for two years.

Statins work by lowering LDL cholesterol or low-density lipoprotein, which in turn lowers the risk of heart attack and strokes.

Complete information was available for 165,411 patients who had not been treated for heart disease or stroke, and who had their cholesterol measured at least once in the year before statin treatment and at least once within two years of starting it.

Fewer than half of all people enrolled over the 26-year study period - 48.8% - achieved target cholesterol levels at the two-year followup mark, with just over half - 51.2% - falling short, according to the study, published Monday in the journal Heart.

"Although this study suggests that not everyone who is prescribed statins manages to reduce their cholesterol sufficiently, it doesn't explain why".

After taking account of potentially influential factors, including age, cholesterol level and any underlying conditions before treatment, patients who failed to reach a 40% reduction after two years were 22% more likely to develop cardiovascular disease than those who did respond well.

However, in the current study, half of the patients did not achieve this target and were at a 22% greater risk for developing cardiovascular disease than those who did achieve the target.

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"If you have been prescribed statins, you should continue to take them regularly, as prescribed".

Prof Helen Stokes-Lampard, chairwoman of the Royal College of Global Positioning System, said: "When we prescribe medication, we have to rely on patients to make sure that they take it, both at the recommended dose and for the duration of time that we think will benefit them most".

'We would encourage anyone who is on regular medication to attend their scheduled medication reviews and to raise any queries or concerns they might have.

"Currently, there is no management strategy in clinical practice which takes into account patient variations in [low density cholesterol] response, and no guidelines for predictive screening before commencement of statin therapy", they highlight.

Commenting on the finding that many patients had a "sub-optimal" response, Avkiran suggests "it may be that these people have been prescribed low dose or low potency statins, that they are not taking the medication as prescribed, or that they are not responding well to the type of statins that they have been prescribed".

Writing in a linked editorial, Marcio Bittencourt, from Sao Paulo's University Hospital, said the study's results were "clearly alarming". Some 12,142 arose in those who failed to reach a healthy cholesterol; 10,656 arose in those whose cholesterol did drop by 40 per cent.

Akyea stressed that the study - the largest of its kind to date - could not establish why some patients responded positively to statins while others didn't. The exact dosage of statins prescribed and patients' compliance to the prescriptions were not within the scope of the research.

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