Some People Taking Statins Might Be Able to Lower the Dose
If you had a heart attack months or years ago, you're probably on a hefty dose of a cholesterol-lowering statin drug to prevent a future heart attack, stroke, or other cardiovascular event. Could you get by with less? These drugs can be expensive, and the possibility of side effects increases with dosage and the potency of the chosen statin. But no one had investigated whether a high dose of a powerful statin lowers the risk of dying after an attack more than a lower dose of a less potent one–until now.
It turns out that many people probably can scale back their dosage (and save money). A review of four clinical trials published in the May issue of Circulation found that patients hospitalized for a heart attack who were started on the maximum allowable dose of Lipitor, a high-octane statin, did have a 25 percent lower mortality rate over two years compared with those given a moderate dose of Zocor, which is cheaper and somewhat less powerful. But the drug made no difference in the death rates of stable patients who had suffered heart attacks months or years before.
"We did see slightly lower rates of heart attacks and strokes" in the Lipitor patients, says study leader Paul Chan, a cardiovascular fellow at University of Michigan Medical School, but not their rate of death. Chan recommends reserving the higher dose for people with acute heart problems and giving the lower dose to those who have had no heart attacks in the previous two years.