Table of Contents
By Cardiologist Christopher P. Cannon, MD; Leonard S. Lilly, MD, Chief, Brigham and Women’s/Faulkner Cardiology; and Jorge Plutzky, MD, Director, Vascular Disease Prevention Program/Lipid and Prevention Clinic, Brigham and Women’s Hospital
Heart disease is the number one killer of women and men in the United States. As more information is learned through research and clinical trials, Americans and people around the world are able to take better control of their heart health and reduce their risk.
The physicians of Brigham and Women’s/Faulkner Hospitals – who are often at the forefront of the latest research – have access to the information you need to live a heart healthier life.
Super Statins
Statins have revolutionized the way cholesterol levels are controlled in people who have established heart disease and those who are at increased risk for heart problems. Statins mainly work by potently reducing the levels of bad cholesterol (LDL) although they also have some effect on raising the levels of good cholesterol (HDL).
If you have been diagnosed with heart disease, have experienced a heart attack or have diabetes, you should probably be taking a statin. If you do not have heart disease or diabetes, but have certain risk factors for heart disease associated with high cholesterol – including smoking, high blood pressure, and family history of heart disease – the greater your need for a statin.
New research shows that, for people who have had a heart attack or other cardiac event, immediate high-dose statin therapy may provide even more of a benefit. The Facts:
- Statins (with brand names such as Crestor®, Lipitor®, Pravacol®, and Zocor®) are a class of successful, widely used drugs that reduce cholesterol production. This is thought to be their main effect on lowering the risk of heart disease;
- Statins reduce the risk of death, heart attack, need for cardiac procedures, and stroke;
- Statin therapy also may benefit patients who have high levels of C-reactive protein (CRP), a substance produced in the liver
when arteries are inflamed (a person can have low cholesterol but still be at high risk for heart disease if they have high levels of CRP);
- Extensive evidence indicates that statins are not only very safe but also very well-tolerated in the vast majority of patients;
- There are studies that have raised concern that many of the individuals who would benefit from statin therapy are often not getting tested, treated, or treated to achieve the best cholesterol levels.
Available for about 15 years, the use of statins has been steadily increasing as important and clear-cut benefits have been revealed in carefully executed independent clinical studies.
Recognized as a “miracle drug” for the prevention of heart disease, research has now shown that – for those patients who have recently suffered a heart attack or unstable angina – a stronger dosage given sooner is even more powerful than the standard dose in reducing their risk of future heart attack, stroke or other cardiovascular event. Researchers at Brigham and Women’s Hospital lead the multi-national PROVE IT – TIMI 22 study released in early March that showed, compared to the standard-dose statin therapy, high-dose statin therapy resulted in a 50 percent reduction in low density lipoprotein (LDL) resulting in a greater reduction in death or major cardiac events and more intensive lowering of cholesterol.
The research also showed that these patients benefit from having their LDL at a level even lower than current guidelines of 100 mg/dl for those people at average risk for heart disease.
If you have cardiovascular disease, or think you are at high risk for heart attack or stroke (especially if you have diabetes, high blood pressure or smoke), you should speak with your doctor about your specific cholesterol goals and the appropriate statin dose to help prevent future heart problems.
Research Review
Recent heart health research findings from Brigham and Women’s Hospital include:
New Blood Test Following Heart Attack May Help Determine Mortality Risk (Circulation, April 19, 2004): Brigham and Women’s Hospital researchers found a protein in the blood, called ST2, that may one day produce a simple and inexpensive test to help determine who is at high risk for problems following a heart attack. The study indicated that heart attack victims with elevated levels of the protein, that is produced when stress is put on heart cells, were seven times more likely to die in the month following the heart attack compared to patients with the lowest levels of the blood marker.
Moderate Alcohol Consumption Decreases Risk of Cardiovascular Disease Death in Men (Archives of Internal Medicine, March 22, 2004): Brigham and Women’s Hospital researchers found that light to moderate alcohol consumption – one to two drinks a day – among men with hypertension, could help reduce the risk of death from cardiovascular disease. These findings call into question current guidelines that recommend patients with high blood pressure should avoid alcoholic beverages. Caution is always appropriate when it comes to alcohol intake given the many potential problems it can cause when taken in excess or at inappropriate times. Alcohol intake is not recommended as the part of any national guidelines.
High CRP Levels in Women Shown to Predict Hypertension (Journal of the American Medical Association, December 10, 2003): In an eight-year study of more than 20,000 women, Brigham and Women’s Hospital researchers found for the first time that high levels of C-reactive protein (CRP), a marker of inflammation proven to predict risk of heart attack and stroke, may also predict the future development of high blood pressure. These groundbreaking findings provide key evidence that high blood pressure may be part of a low level inflammatory reaction. This breakthrough may also provide critical insight both for the early detection of those at risk for high blood pressure and for the development of novel therapies to treat high blood pressure. Testing for CRP has been a major focus of attention in the news, in large part due to pioneering work done at Brigham and Women’s Hospital.
Call 1-877-BWF-5773 to Make An Appointment for Your Heart Health
Our Cardiovascular Center can provide you with the services and information you need to take control of your heart health. If you need a specialist, call 1-877-BWF-5773 or use our on-line appointment request form to schedule an appointment. Also, call or use our on-line publication request form to request our free guide “Heart Smart for Life”.
