Taking cholesterol-lowering drugs known as statins can help prevent cardiovascular disease. For people who already have cardiovascular disease, might high doses of statins be beneficial?
The researchers analyzed data on 509,766 adults (average age 68) who had some type of cardiovascular disease caused by plaque buildup in their arteries. All but 18 percent were taking statins, with about 30 percent on high doses, 45 percent taking moderate doses and 7 percent on low doses.
Dosage examples included 40 to 80 milligrams of Lipitor (atorvastatin) for high-dose treatment and 10 to 20 milligrams for a moderate dose. For Crestor (rosuvastatin), 20 to 40 milligrams was a high dose, and five to 10 milligrams was considered a moderate dose.
After about a year, the higher someone’s dose of statins, the less likely they were to have died. Mortality rates were 4 percent for those on high-dose treatment, compared with 5 percent for moderate-dose treatment, 6 percent for low-dose and 7 percent for people who did not take statins.
Comparing only the high-dose and moderate-dose groups, the more-intensive treatment yielded a 9 percent boost in survival. This applied regardless of age, with people older than 75 experiencing the same benefit as younger people.
People whose cardiovascular disease was caused by narrowed or clogged arteries. This includes coronary artery disease as well as cerebrovascular disease, which involves clogged arteries that carry blood to the brain, and peripheral artery disease, which most often affects arteries carrying blood to the legs but also can affect the stomach, arms and head.
Most people who take statins do so to slow the formation of plaque and thus reduce their risk for cardiovascular disease. Guidelines and expert opinions differ on statin dosage for people with existing cardiovascular disease, especially those older than 75.
Longer-term benefits and risks of high-dose treatment were not tested. The data did not indicate causes of death.
Online Nov. 9 in JAMA Cardiology (jamacardiology.com).
The research described in Quick Study comes from credible, peer-reviewed journals.