Statins lower cholesterol, but not necessarily heart attack risk, study finds

March 14 (UPI) -- The effectiveness of cholesterol-lowering medications in reducing a person's risk for heart disease depends on their underlying risk for heart problems, an analysis published Monday by JAMA Internal Medicine found.

In other words, being overweight, smoking and having high blood pressure can increase a person's risk for heart disease, heart attack or stroke, and their risk may remain high even if their cholesterol is controlled with prescription drugs, the researchers said.

Based on data from 21 clinical trials of cholesterol-lowering drugs called statins, people taking these medications saw their risk for a heart attack or stroke drop by less than 1%, the data showed.

"Although statins undoubtedly reduce cholesterol, some trials showed that this translated into significant reductions in death, heart and stroke and some trials [did not]," study co-author Paula Byrne told UPI in an email.

"The benefits of statins depend on a person's baseline risk of [heart disease, so] an overweight, smoking 65-year-old man with high blood pressure and cholesterol would have a very different risk than a 50-year-old non-smoking woman of healthy weight," said Byrne, a researcher with the Health Research Board in Dublin, Ireland.

Statins are prescription drugs that, when combined with diet and exercise, can reduce blood levels of low-density lipoprotein, or LDL, cholesterol, or so-called "bad cholesterol," according to the Food and Drug Administration.

Examples of statins include atorvastatin, which is sold under the brand Lipitor, and rosuvastatin, which is sold under the brand name Crestor.

Statins are some of the most commonly prescribed medications in the United States, with recent research finding that as many as half of adults age 75 years and older nationally use them.

However, a report from the American Heart Association suggests that they and other heart-health treatments may be overprescribed, meaning some people taking them may not experience any benefits.

Byrne and her colleagues analyzed data from 21 clinical trials of statins that collectively enrolled more than 130,000 participants.

Although the trials generally found that the drugs were effective at lowering bad cholesterol, and reduced the risk for heart attack and stroke in many of those taking them, the benefits for others were "marginal," Byrne said.

This was particularly true for those who did not make lifestyle changes in conjunction with statin treatment, such as eating a healthy diet, quitting smoking, exercising and maintaining a healthy weight, she and her colleagues said.

"The study suggests that the assumption of the 'lower the better' in terms of LDL cholesterol is not supported by the findings," Byrne said.

"We'd advise anyone concerned about taking statins to have a conversation with their doctor, find out what their baseline risk is and by how much this would be reduced by taking a statin -- then the person can make an informed decision with their doctor," she said.