An Israeli study has confirmed that continuing treatment with statin drugs, which are known to lower bad cholesterol levels in people at risk of heart disease, reduces the likelihood of death.
Dr. Varda Shalev, from Maccabi Healthcare Services and Sackler Faculty of Medicine in Tel Aviv, says that patients with high cholesterol levels who continually take statins appear to have a lower risk of death over four to five years, regardless of whether they already have diagnosed heart disease.
While several clinical trials have shown the benefits of statins in controlling risk factors and preventing death in patients who already have heart disease, some have questioned their effectiveness in patients taking them for delaying or preventing the development of cardiovascular disease.
Shalev's team analysed data from 229,918 adults enrolled in a health maintenance organization who began taking statins between 1998 and 2006.
The patients, whose average age was 57.6, included 136,052 individuals without heart disease, who were followed for an average of four years, and 93,866 already diagnosed with heart disease, with an average five years of follow-up.
The researchers checked pharmacy records to calculate the proportion of days that each individual took statins.
During the study, 8,906 patients with heart disease and 4,259 without it died. In both groups, continuity of taking statins-defined as taking statins for at least 90 percent of the follow-up period-conferred at least a 45 percent reduction in the risk of death compared with patients who took statins less than 10 percent of the time.
The risk reduction was stronger among patients with high levels of cholesterol at the beginning of the study, and among patients whose initial treatment was with high-efficacy statins.
"In conclusion, this study showed that the continuation of statin treatment provided an ongoing reduction in all-cause mortality (death) for up to 9.5 years among patients with and without a history of coronary heart disease," say the researchers.
"The observed benefits from statins were greater than expected from randomized clinical trials, emphasizing the importance of promoting statin therapy and increasing its continuation over time for both primary and secondary prevention," they add.
The study has been reported in the Archives of Internal Medicine, one of the JAMA/Archives journals.