Results from PROVE-IT demonstrated that for high-risk patients, intensive statin therapy is more effective than standard therapy in lowering LDL cholesterol and C-reactive protein (CRP) levels, and that CRP levels predict risk even when LDL cholesterol has been lowered substantially. The REVERSAL data suggest that intensive statin therapy produces greater reductions in LDL and CRP levels, and that the more that statins can lower LDL, the more effective they are in reducing the progression of atherosclerosis.
An important 2006 study found that aggressive treatment with rosuvastatin (Crestor):
- Helped lower LDL to below guideline levels
- Moderately increased HDL levels
- Reduced fatty plaque in the arteries
These results suggest that statin therapy might have the potential to reverse coronary atherosclerosis. Future studies will explore whether other statins have a similar positive effect on coronary artery disease. Rosuvastatin lowers LDL more than other statins, but it also carries greater risks for more serious side effects (see Adverse Effects section.) Many experts believe that the more that LDL is reduced through statin therapy, the greater the reduction in risk for heart disease, heart attack, and stroke.
Evidence indicates that cholesterol-lowering drugs improve survival in heart attack patients. However, a 2001 study reported that only about a fourth of patients have their cholesterol checked after a heart attack, and only about 30% with unhealthy cholesterol levels are prescribed cholesterol-lowering drugs. In addition, research presented at the 2004 annual scientific sessions of the American Heart Association demonstrated ethnic disparities in cholesterol management. According to the data from the Multi-Ethnic Study of Atherosclerosis (MESA), Hispanics and non-Hispanic blacks were less likely to receive adequate drug treatment than non-Hispanic whites.
It is important to emphasize that cholesterol-lowering medications are used along with healthy lifestyle habits, not in place of them. In spite of these guidelines, fewer than half of people who would presumably benefit from cholesterol-lowering drugs are taking them.
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