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Arrest-ed development?
Heart disease is the leading cause of death in the US, killing around 700,000 Americans each year.
New research estimates that nearly 50,000 US lives could be saved annually with a one-two punch of cholesterol-lowering drugs.
According to Maciej Banach, a cardiology professor at the John Paul II Catholic University of Lublin in Poland, the combined treatment is both safe and effective.
High cholesterol causes plaque buildup in arteries, which can restrict blood flow and lead to heart attack or stroke.
Statins, which reduce cholesterol levels, are commonly prescribed to people at high risk for heart attack or stroke.
Banach recommends that prescribing a statin alongside the cholesterol-lowering medication ezetimibe to patients can significantly reduce the risk of early death by 19%, a major cardiovascular event by 18%, and a stroke by 17% compared to using statins alone.
The results, which were published in the Mayo Clinic Proceedings on Sunday, present a different viewpoint from the common belief that patients should wait for a minimum of two months after starting a high-dose statin before adding ezetimibe to their treatment plan.
Banach’s team made the recommendation after analyzing the results of 14 studies, including more than 108,000 patients with blocked arteries.
“This study confirms that combined cholesterol-lowering therapy should be considered immediately and should be the gold standard for treatment of very high-risk patients,” study co-author Peter Toth said.
“Simply adding ezetimibe to statin therapy, without waiting for at least two months to see the effects of statin monotherapy, which is suboptimal in many patients,” Toth continued, “is associated with more effective LDL [cholesterol] goal achievement and is responsible for significant incremental reductions in cardiovascular health problems and deaths.”
Cardiovascular disease kills around 20 million people a year worldwide thanks to the prevalence of high blood pressure, cigarette use, obesity, physical inactivity, diabetes and high cholesterol.
Nearly 94 million Americans 20 and up have what could be considered borderline high cholesterol.
Statins reduce the liver’s production of cholesterol, leading to lower levels of plaque-forming LDL cholesterol in the blood.
Ezetimibe (brand name: Zetia) blocks the small intestine from absorbing cholesterol.
“[The combination] approach does not require additional funding or reimbursement of new expensive drugs,” Toth said. “In fact, it may translate into lower rates of first and subsequent heart attacks and stroke, and their complications like heart failure, which are extremely costly for all healthcare systems.”
Dr. Benjamin Hirsh, director of preventative cardiology at North Shore University Hospital, said he hopes early combination therapy becomes the new standard.
“It is very important that patients and physicians, in particular, realize that aggressive reduction of LDL cholesterol is paramount, particularly for the highest-risk patients,” Hirsh told The Post.
“Physicians often take a ‘wait and see’ approach to see how patients initially respond to statin therapy,” he added, “for very high-risk patients, there is no reason to wait.”