New hope for high-risk heart patients

Experts are seeing new hope in improving survival of high-risk heart patients. Tens of thousands of deaths each year may be prevented with the use of the class of cholesterol-lowering drugs called statins.

Heart experts worldwide are calling for a major change in treatment guidelines recommending statins in high-risk patients even if their blood cholesterol levels are just slightly elevated or still within normal limits. It is predicted that the results of recent landmark trials are set to revolutionize the way cholesterol-lowering drugs are prescribed.

Available scientific data published in prestigious international journals show that using statin drugs to lower blood cholesterol levels protects a far wider range of people at risk of heart attacks and strokes than had been previously shown.

According to Dr. Gregorio Patacsil, past president of the Philippine Heart Association (PHA), Philippine College of Physicians (PCP) and Philippine Society of Hypertension (PSH), statins are often prescribed previously only to people who have heart disease and elevated cholesterol levels.

But with the new findings from the 20,000-patient Heart Protection Study (HPS) conducted in the United Kingdom, he believes that there is now strong evidence showing that statins also cut the risks of heart attacks and strokes in high-risk population which includes patients with diabetes, narrowing of arteries in their legs, and a history of heart attack or stroke. Simvastatin was used in the HPS.

"Even those high-risk patients considered to have normal or low cholesterol levels benefited from the use of simvastatin," adds Patacsil, cardiology consultant at the University of the Philippines-Philippine General Hospital and Capitol Medical Center.

He supports the recommendation that guidelines should be changed so that irrespective of the blood cholesterol level, a statin is considered for anybody at increased risk of either heart attacks or strokes.

Health experts estimate that implementing the new findings of the HPS and other statin trials fully would more than triple the number of people benefiting from statins.

However, heart specialists worldwide lament that the big hindrance to optimal long-term compliance with statin therapy is its high cost of treatment. Local medical practitioners welcome the introduction of an affordable simvastatin (Vidastat) by Therapharma, which can maximize the benefits of statins among Filipino heart patients.

Another important HPS finding is that it established firmly that statin treatment is safe. Professor Peter Sleight, deputy chairman of the HPS Steering Committee, says, "HPS should reassure doctors and patients about both the safety and the benefits of statins. It provides clear evidence that statin use safely cuts the risks not just of heart attacks but also of future strokes by about one-third. These findings open the door to treatment for many patients who are currently unlikely to receive a statin in the UK or elsewhere."

Although statins, as a class of drugs, are generally expensive, its use is considered cost-effective and may turn out cheap in the long run considering the reduction in strokes, heart attacks, repeated hospitalizations and clinic consultations.