Higher statin dose cuts heart risk in elderly

By David DouglasThu Jul 12, 3:19 PM ET
For elderly patients with coronary disease, treatment with high doses of cholesterol-lowering Lipitor (known generically as atorvastatin) reduces the risk of heart-related events more than low doses, according to a new report.
Aggressive lowering of LDL ("bad") cholesterol with high doses of atorvastatin, compared with routine cholesterol lowering with low doses, produces additional clinical benefit in elderly heart patients, Dr. Nanette K. Wenger told Reuters Health.
Wenger, of Emory University School of Medicine, Atlanta and colleagues came to this conclusion after analyzing data on some 3800 subjects aged 65 years or more who formed part of a group of 10,000 people with coronary disease who were taking part in a clinical trial of atorvastatin.
As reported in the Annals of Internal Medicine, all patients had LDL cholesterol levels below 130 points and were randomly assigned to take 10 milligrams or 80 milligrams of atorvastatin daily.
The usual goal of cholesterol-lowering is to get LDL levels below 100 milligrams per deciliter of blood, but recent guidelines have suggested that the target should be lower for anyone with actual coronary heart disease.
The investigators found that the high-dose regimen led to LDL levels of about 70, while with low-dose treatment the levels were about 100.
The likelihood of suffering a heart attack or stroke or cardiac arrest was 19 percent lower with high-dose atorvastatin compared to low-dose treatment.
Moreover, mortality rates among high-dose patients were lower than was the case for their counterparts on the low-dose regimen.
The researchers conclude that "additional clinical benefit can be achieved by treating older patients with coronary heart diseases more aggressively to reduce low-density lipoprotein cholesterol levels to less than ... 100 mg/dL."
SOURCE: Annals of Internal Medicine, July 3, 2007.