IF you suffer from stable heart disease, a higher dose of the class of cholesterol-lowering drugs known as statins might decrease the risk of heart attacks and strokes for you, a new study shows.
The study, funded by Pfizer, and called Treating New Targets, or TNT, showed that the top dose of Atorvastatin calcium decreased the risk of heart attacks and strokes in people with stable heart disease, compared to the lowest dose of the same drug.
"Atorvastatin calcium is a prescription medicine used with diet to lower cholesterol," said Dr Graham Jackson, a British-based consultant cardiologist, who was in Kuala Lumpur last week. "Lowering cholesterol levels is a proven strategy in reducing the risk of heart attack and heart disease but it is not certain what the appropriate target for lowering cholesterol should be in individuals with known heart disease. This study helped determine that. The results could potentially change the standard of care for patients with CHD."
The five-year Treating to New Targets Trial (TNT) involved 10,000 patients with established coronary heart disease and elevated LDL, or "bad" cholesterol levels. The study assessed whether patients on high-dose Atorvastatin calcium who aggressively lowered their LDL-cholesterol levels to well below the current guidelines (100 mg/dL) would experience additional cardiovascular benefits compared to Atorvastatin calcium patients who maintained their LDL-cholesterol at recommended levels.
Patients who received 80 ma doses of Atorvastatin calcium had 22 per cent fewer cardiovascular events, including CHD death, non-fatal heart attacks, resuscitated cardiac arrest, and fatal or non-fatal strokes compared to patients who took 10 mg of Atorvastatin calcium. In addition, patients treated with high- dose Atorvastatin calcium had 25 per cent fewer fatal or non-fatal strokes compared to those treated with just 10 mg of Atorvastatin calcium.
Dr Sim Kui-Hian, head of both the department of Cardiology and the Clinical Research Centre at the Sarawak General Hospital, said that the average cholesterol levels of the Malaysian population have been increasing since 1961 and the majority of Malaysians with elevated cholesterol are not at their recommended goal levels.
"This is despite the fact that coronary heart disease is the leading cause of death in Malaysia," said Dr Sim.
"Everyone hates taking medicine," he said. "But this drug is generally well tolerated. Adverse reactions usually have been mild and transient, with the most frequent adverse effects of atorvastatin being constipation, flatulence, dyspepsia and abdominal pain."
"The mainstay of treatment; besides medication, is exercise, diet and maintaining a healthy body weight," said Dr Sim. If patients are on a higher dosage of atorvastatin coupled with exercises, not smoking, maintaining correct blood pressure and controlling diabetes, coronary vascular diseases can be remarkably reduced by 80 per cent.
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