Two recent studies have confirmed the benefits of therapy with statins, a class of prescription drugs also known as HMG-CoA reductase inhibitors that lowers cholesterol levels. The studies demonstrated that statins can help prevent cardiovascular “events,” such as heart attacks, both in people with diabetes who don’t have cardiovascular disease and in those who have already had a heart attack or episode of severe angina (chest pain associated with heart disease).
The first study, published in the journal Archives of Internal Medicine on November 27, reviewed seven previous studies with a total of over 40,000 subjects. The review showed that taking statins reduced the risk of heart attack and stroke even in people who didn’t already have cardiovascular disease. In people who had cardiovascular disease risk factors such as diabetes, high blood pressure, or high blood cholesterol, statin therapy reduced heart attack risk by 29% and stroke risk by 14% compared to placebo therapy over a period of over four years.
These results support the current guidelines established by the National Institute of Health’s National Cholesterol Education Program. These guidelines recommend statin therapy for people who have diabetes even if they have average or below-average LDL (or “bad”) cholesterol levels.
Another study, published in the European Heart Journal in October, showed that statin drugs are just as beneficial in people who have diabetes and a condition called acute coronary syndrome (ACS) as they are in people who have ACS but do not have diabetes. (People are identified as having ACS if they have previously had either a heart attack or an episode of severe angina.) The study, which analyzed a subgroup of people within a larger trial of statin therapy, followed 978 people with ACS and diabetes and 3,184 people with ACS and without diabetes for about two years. Half of the study subjects received intensive statin therapy and the other half received standard statin therapy. At the end of the study, researchers found that intensive therapy had provided a similar magnitude of benefit over standard therapy in both the diabetic and nondiabetic groups in protecting against further heart attacks and angina episodes.
Statins currently available by prescription in the United States are atorvastatin (brand name Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor). Generic versions of lovastatin, pravastatin, and simvastatin are also now available.