People with known heart disease or a major risk factor, such as diabetes, are counseled to reduce their low-density lipoprotein (LDL) cholesterol ("bad" cholesterol) below 100 milligrams/deciliter (mg/dL) of blood. The goal for patients whose only risk factor is high cholesterol is usually below 130 mg/dL. Statin drugs are commonly used to lower total and LDL cholesterol.
There has been some question recently, however, whether more aggressive LDL lowering would confer an even greater benefit, says lead author Allen J. Taylor, M.D., director of cardiovascular research at Walter Reed Army Medical Center in Washington, D.C.
In addition, there is a question of whether factors besides cholesterol-lowering figure into the overall benefit from statin therapy. Besides affecting cholesterol, statins may also affect levels of inflammation or the degree of artery thickening.
"This is the first comparison of two statin drugs in a general population that looked at more than their cholesterol-lowering abilities," says Taylor.
Researchers recruited 161 patients (average age 60, 71 percent men) who were candidates for statin therapy. About half had known cardiovascular disease. Of these patients, 138 completed the study in which they received either 40 milligrams (mg) of the natural drug pravastatin, or 80 mg of relatively new synthetic statin called atorvastatin.
After 12 months, those receiving pravastatin treatment had a 27.5 percent drop in their LDL cholesterol compared to a 48.5 percent reduction in LDL for people treated with the higher dose of atorvastatin. The pravastatin group's LDL was
Contact: Carole Bullock
American Heart Association