Men who take statin drugs for moderately high cholesterol – even if they don't have any history of heart attack – may significantly reduce their risk of heart disease or heart attack, a new study suggests.

"It was a little bit of a surprise," Dr. Doug Manuel, scientist, Institute for Clinical Evaluative Sciences, told CBC News Wednesday. "It's been an area that we're not sure of. It's just helpful information that's been missing in discussion with patients about whether you should think about treating [them] at moderate risk for long periods of time."

Relative risk reductions from coronary heart disease and non-fatal heart attacks among those men taking Pravastatin were 40 per cent during the trial and 18 per cent in the post-trial period.
(CBC)

Manuel said that the study should prompt an evaluation of current treatment guidelines in patients with moderately elevated cholesterol. "I think this reinforces or suggests that we should think as a society about treating at least moderate risk people."

The study of 6,595 men, published in Thursday's issue of the New England Journal of Medicine, was conducted between February 1991 and May 1995. Participants who were chosen, based on their cholesterol level, had elevated LDL, or "bad" cholesterol, with one reading indicating a level of 4 mmol per litre or higher, and one reading of 6 mmol per litre or lower.

Participants were then split into two groups. One was given pravastatin, a drug that lowers LDL while increasing HDL, or "good" cholesterol, and the other group was given placebo.

All participants were tracked and monitored for the onset of heart disease or heart attack.

During the followup period, 619 study participants in the pravastatin group and 674 assigned to placebo died.

When examined, the cardiovascular risk reduction in the pravastatin group was 34 per cent during the trial and 14 per cent in the post-trial period. For all deaths from cardiovascular causes, the event rate during the entire followup period was 7.6 per cent for patients originally assigned to pravastatin, compared to nine per cent of patients originally assigned to placebo.

And relative risk reductions from coronary heart disease and non-fatal heart attacks among those men taking pravastatin were 40 per cent during the trial and 18 per cent in the post-trial period.

"The study showed that in men with hypercholesterolemia [elevated cholesterol] who did not have a history of myocardial infarction [heart attack], statin treatment for an average of five years provided an ongoing reduction in the risk of coronary events for an additional period of up to 10 years," reads the study.

Manuel said that although the study casts statins in a positive light, doctors need to above all discuss lifestyle modifications with their patients. "I think we talk too much about cholesterol," he says. "I think we don't talk enough about what's the best way – should we [change] lifestyle, should we promote public transportation so that people walk more or should we use drugs and surgery once people get disease?"