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New research has confirmed that 50% of patients who are prescribed statins do not reach "healthy" cholesterol within two years of treatment.
Posted in the journal HeartThe findings underscore the need for personalized medicine to combat high cholesterol and reduce the greatly increased risk of future heart disease and stroke. – the leading causes of death in the world – say the researchers.
The cholesterol reduction goals were based on the guidelines of the UK's National Institute for Health and Wellness (NICE)., stipulating a 40% or more reduction in LDL ("bad" cholesterol). The researchers wanted to know how well patients are responding to statins, based on the NICE target, and how this might affect their future risk of cardiovascular disease.
They drew on diagnostic and prescribing data submitted to UK Clinical Practice Research Datalink and linked them to hospital treatment episodes (HES data) and cause of death statistics (ONS data).
Complete information was available for 165,411 patients who had not been treated for heart disease or stroke and for whom their cholesterol level had been measured at least once in the year prior to statin treatment and at least once within two years of starting treatment.
Any reduction in cholesterol below 40% after two years of statin treatment was considered a "suboptimal" response. This applied to half (51%) of the patients.
After taking into account potentially influential factors, including age, cholesterol, and all underlying conditions before treatment, patients who did not achieve a 40% reduction after two years were 22% more likely to develop cardiovascular disease than those who responded well.
Every 1 mmol / L falls into low density Cholesterol was associated with a risk of stroke and ministroke lower by 6% in those who did not reach the 40% target.
But among those who responded well, this was associated with a 13% reduced risk of cardiovascular disease, which generally reinforces the health benefits of reaching the target of 40%, say the researchers.
Several factors may explain the difference in response, but the genetic makeup and inability to stick to treatment may explain some of the observed variations, they suggest.
This is an observational study that does not establish the cause. But, stress the researchers, the results reflect the experiences and concrete results of a lot of people in the real world and should apply to patients from other countries.