A new study finds that heart disease patients who stop taking statins (cholesterol-lowering drugs) after being hospitalized for severe, unstable chest pain (angina) significantly increase their chances of suffering a heart attack or dying in the near-term. An estimated 13 million Americans currently take statins to help lower their cholesterol, and recently revised guidelines from the National Heart, Lung, and Blood Institute encourage 23 million more Americans to begin statin therapy. Experts say the study reinforces the significant benefits of statins in helping to prevent major cardiac events and even death. Patients who have been advised to discontinue statins are encouraged to ask for a specific explanation from their physicians.
Heart disease is the leading cause of death in the United States and is a serious worldwide problem. Approximately 12,800,000 Americans suffer from coronary artery disease and nearly 500,000 Americans die each year from heart attacks. Over 12 million Americans have a history of heart attack, chest pain (angina), or both. In an effort to reduce the number of heart disease cases, physicians emphasize maintaining low cholesterol levels and low blood pressure; eating a diet rich in fruits and vegetables and low in fat; maintaining a normal weight; not smoking; exercising regularly; and reducing stress levels. In recent years, the increased use of statins has helped lower cholesterol levels in many people at high risk for heart disease.
To determine the effectiveness of statins immediately after hospitalization, lead researcher Dr. Christian Hamm, from the Kerchief Heart Center in Germany, and his team followed over 1,600 men and women who had been admitted to the hospital due to acute coronary syndrome, a type of heart disease characterized by unstable chest pain (angina). In the study, 1,151 of the patients had never taken statins, 379 patients had taken statins for six months, and 86 patients had taken statins for at least six months but had stopped after they were hospitalized (for unknown reasons).
Dr. Hamm and his colleagues found that the patients who continued taking statins were far less likely to suffer a heart attack or die within 30 days of their hospitalization, compared to the patients who quit the medication. Furthermore, the patients who stopped taking statins were nearly 70% more likely to have a heart attack or die compared to patients who had never took statins, suggesting that the act of stopping statin therapy poses significant health risks to severely ill patients. In fact, the researchers acknowledge that statins may offer additional benefits to patients who suffer from acute coronary syndrome, since cholesterol levels did not appear to account for the increased heart attacks and deaths among the patients who quit taking statins.
Based on the study results, Dr. Hamm and his team conclude that halting statin therapy for patients with unstable heart disease obliterates the drugs' beneficial effects and therefore should be avoided. However, experts say that few physicians would encourage their cardiac patients to discontinue statins, especially after being hospitalized for unstable chest pain or similar symptoms. Nevertheless, the study reinforces the need for patients to be aware of the important protection statins provide and to question their physicians if they are advised to stop taking statins.
The researchers also emphasized that statins are most beneficial when taken as preventive therapy before cardiac events occur.
Examples of statins used to lower cholesterol:
- Lipitor (generic name, atorvastatin)
- Mevacor (generic name, lovastatin)
- Pravachol (generic name, pravastatin)
- Zocor (generic name, simvastatin)
Patients with high cholesterol should talk to their physicians about dietary modifications and whether drug therapy would be helpful. The U.S. government recently recommended treating high cholesterol more aggressively in people with diabetes.
- The study referenced in this article is published in the March 26, 2002 issue of the journal, Circulation, http://circ.ahajournals.org/
- The March 4, 2002 HealthScoutNews report by Adam Marcus is entitled, "Discontinuing Cholesterol Drugs Can Be Deadly."
- The May 21, 2001 Imaginis report, "New Guidelines Emphasize Aggressive Measures to Lower Cholesterol in Millions of Americans," is available at http://www.imaginis.com/heart-disease/news/news5.21.01.asp
- To learn more about heart disease, please visit http://www.imaginis.com/heart-disease/
