CHAPEL HILL Aggressive therapy with statins -- drugs that inhibit cholesterol synthesis -- works better than moderate statin therapy in reducing fats and proteins in the blood that have been linked to atherosclerosis, a new multi-center study concludes. Statins' effects on both complex compounds appear beneficial in cutting patients' cardiovascular risks.

Atherosclerosis is the progressive disease process, often called hardening of the arteries, in which blood vessels slowly narrow with brain- and heart-threatening plaque, something like rust blocking water flow in an iron pipe.

A report on the research appears in Thursday's (Jan. 6) issue of the New England Journal of Medicine.

More than three dozen investigators from across the country participated in the research, including first author Dr. Steven E. Nissen of the Cleveland Clinic Foundation and Dr. Sidney C. Smith Jr.

A past president of the American Heart Association, Smith is professor of medicine and director of the Center for Cardiovascular Science and Medicine at the University of North Carolina at Chapel Hill School of Medicine. He also served on the steering committee of a second, closely related investigation appearing in the same issue and led by Dr. Paul M. Ridker of Harvard Medical School and others.

Scientists designed the first study to investigate the relative contributions of statins in lowering fats in blood and also C-reactive protein (CRP), the most reliable laboratory measure of systemic inflammation in the body. It involved performing ultrasound tests on 502 U.S. patients with documented coronary artery disease.

Half the patients then received 40 milligrams of pravastatin, while the rest underwent the more aggressive treatment of 80 milligrams of atorvastatin. Doctors repeated the ultrasound evaluations 18 months later.

In the group as a whole, the mean LDL cholesterol level dropped from 150.2 milligrams per deci
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Contact: David Williamson
919-962-8596
University of North Carolina at Chapel Hill
5-Jan-2005

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