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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.
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