Heart: Is "bad" cholesterol not reduced enough in half of patients on statins?



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Half of the patients who received statins as a preventive measure for "Bad" blood cholesterol does not reach the "Healthy" two years after receiving treatment, according to a study published on Tuesday. The prescription of drugs called statins to "Bad" cholesterol, LDL (or LDL-C), in patients who have already had a heart attack, debate little in the context of so-called secondary prevention. Its place in primary prevention in individuals free of stroke or heart problems (angina pectoris, heart attack), however, remains controversial.

However, there are recommendations to prescribe them for primary prevention in people at risk (smoking, hypertension, overweight, diabetes, high LDL, age …), with nuances that depend on the country, note the authors of this British study. . According to this study, published in the journal Heart Card, 84,609 patients (or 51.2%), mean age 62 years, did not reach the recommended goal of 40% reduction after starting treatment. cholesterol for two years. 48.6% of these patients without a history of cardiovascular events were women. All started treatment between 1990 and 2016.

Patients who failed to achieve the goal of a 40% reduction after two years would be 22% more likely to develop cardiovascular disease than those who achieved it, according to the team. Dr. Stephen Weng (University of Nottingham). Failure to follow prescribed treatment and genetic variations may explain some of these differences in response to statins, the authors suggest. However, the study does not establish the cause, that is, why some patients respond to treatment and others do not. These differences in outcomes among patients could be due to differences in cardiovascular risks, more or less high at the beginning, notes emeritus professor of statistics Kevin McConway at the Open University.

He also noted that the authors "had no data on smoking (main risk factor, note) of 4% of people studied and body mass index data for only 55% (for overweight, ed). In an editorial in the Heart, Marcio Bittencourt, from the University Hospital of São Paulo, "clearly alarming" insufficient therapeutic results. Statins significantly reduce the risk of heart attack and stroke in a high percentage of patients at risk, he says, adding that "anti-statist propaganda based on pseudoscience must be strongly denied".

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