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STATINS FOUND TO CUT RISK OF STROKE CHOLESTEROL DRUGS CURBED DEATH RATE
Boston Globe , Wednesday, July 23, 1997
Richard Saltus, Globe Staff
Edition: Third , Section: National/Foreign , Page: A3

An analysis by Boston scientists has resolved a worrisome paradox about potent cholesterol-lowering drugs called statins and shown for the first time that they cut the risk of strokes and the death rate from heart attacks.

Previous studies had shown that people who reduced high cholesterol levels with the drugs had fewer heart attacks than those who didn't, but researchers could not demonstrate that the death rate dropped. That led to fears that some unknown side effect was offsetting the heart attack benefit.

Researchers from Harvard Medical School and Brigham and Women's Hospital, however, say their analysis, combining 16 previous studies with 29,000 people, shows "clear evidence" that the drugs reduce risk of heart attacks and strokes as well as the overall death rate. They found no evidence that they cause cancer or other fatal diseases, they report in today's Journal of the American Medical Association.

"This should reassure clinicians and their patients that lowering cholesterol will have a beneficial effect on total mortality," said Dr. Charles H. Hennekens, who heads the Division of Preventive Medicine at the Brigham and is an author of the study. The lead author is Patricia R. Hebert, formerly at the Brigham and now at Vanderbilt University School of Medicine.

The new analysis showed that in addition to reducing heart attacks, the drugs lowered stroke risk by 29 percent and total mortality by 22 percent. The previous studies "were too small to detect the effect" of the drugs on strokes and deaths," but lumping the data together revealed it, Hennekens said.

Statins, introduced in the late 1980s, include drugs sold under the names Mevacor, Pravacol, Zocor, and Lescol. More effective than older cholesterol-lowering drugs, the statins reduced LDL, the "bad" cholesterol, by an average of 30 percent, and total cholesterol by 22 percent.

Researchers had predicted that lowering cholesterol would reduce the risk of stroke, since most strokes in the United States stem from fatty plaques inside arteries, but the previous studies had not confirmed this.

Dr. James Cleeman, coordinator of the National Cholesterol Education Program, called the new report "a very important contribution" and said it is "very reassuring" that the analysis found no increase in cancer or any other diseases.

Cleeman said that as of a year and a half ago, an estimated 8 million to 9 million Americans were taking the cholesterol-lowering drugs.

Hennekens cautioned that the drugs have side effects, though they are not as dangerous as was feared, and not everybody with high cholesterol should be taking them.

Hennekens added that cholesterol levels alone do not determine a person's risk of heart disease or stroke. But the more risk factors a person has, including high blood pressure, smoking, and diabetes, among others, the more critical it is to reduce cholesterol.

SALTUS;07/22 NKELLY;07/23,07:50 STROKE23

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