Patients who were on lower dose statins did just as well at lowering their cholesterol as those who were on moderate to high intensity statin medications, according to a new study presented at Touro College Research Day. The results call into question newer recommendations that advocated for more aggressive treatment of cholesterol.
In 2013, the American College of Cardiology and the American Heart Association issued controversial new guidelines recommending moderate to high intensity doses of statins to more aggressively lower low density lipoprotein (LDL), the bad cholesterol. “It was controversial because essentially it resulted in 12.8 million more people being placed on these statin drugs,” says the study’s lead author Martha Rumore, PharmD, Associate Professor of Social, Behavioral & Administrative Pharmacy at the Touro College of Pharmacy.
She and fellow researchers wanted to compare the older ATPIII guidelines, from the National Cholesterol Education Program (NCEP), which recommend lower doses of statins, to the newer guidelines that recommend starting on moderate to high intensity statins.
The retrospective study included 159 men being treated by the Veterans Association. Researchers compared those who were started on low dose statins to those started on moderate to high dose statins. They measured what percent reached the target goal of <100 LDL and what percent reduced their LDL by 40 percent.
The study showed that that 57 percent of those started on low statins achieved the target of <100 LDL compared to just 53 percent of those on high to moderate statins. In addition, 38 percent of those on low statins achieved both the target LDL goal and a 40 percent reduction in LDL, while 43 percent of those on moderate to high statins achieved both goals. The authors concluded that initiating patients on high dose statins was no more effective than starting them on low dose statins.
“The study suggests that maybe not all patients need to be on moderate to high intensity statins to achieve their goal,” says Rumore. “It’s uncertain whether these new guidelines are going to provide any additional benefits compared to the previous ATPIII guidelines, though more research is needed to confirm the results.”