TUESDAY, June 21 (HealthDay News) -- High doses of the widely
popular cholesterol-lowering drugs known as statins may have a
A new meta-analysis finds that intensive doses of statins, such
as Lipitor and Zocor, upped the risk of being diagnosed with type 2
diabetes compared with moderate doses of the drugs.
But the review still revealed a lower incidence of heart
attacks, stroke and death, meaning the balance remains tipped in
favor of taking statins to protect your heart.
"The benefit with respect to heart protection still favors high-dose statins because those taking high doses of statins often have heart disease so are at very high risk of further events," said Dr. Kausik K. Ray, senior author of a paper published in the June 22/29 issue of the Journal of the American Medical Association.
"Patients should get annual checks of blood sugars and, if elevated, be treated appropriately," added Ray, a professor of cardiovascular disease prevention at St. George's University of London. "Of the agents tested, the net benefit was better with high-dose atorvastatin [Lipitor] as compared with high-dose simvastatin [Zocor]."
Statins have been very successful in lowering cholesterol levels
and are used in people with and without diabetes, which is a major
risk factor for cardiovascular disease.
According to Ray, only about 20 percent of patients taking
statins are on high doses. About 80 percent take low to moderate
Ray, along with colleagues from the University of Glasgow,
pooled data from five randomized studies comparing intensive statin
treatment with more moderate doses.
Essentially, all of the studies involved Lipitor and Zocor,
either comparing them against each other, or comparing different
doses of the same medication.
All together, they involved almost 33,000 participants and an
average follow-up of almost five years.
People taking high doses (80 milligrams) of one of these drugs
had a 12 percent higher risk for new-onset diabetes but a 16
reduced risk of cardiovascular events, compared with moderate
That translates to one new case of diabetes for every 500
patients treated for one year with a high-dose statin compared with
one fewer patient having a stroke or heart attack for every 155
patients treated for one year.
But the study had a number of limitations, other experts
For one thing, it was a meta-analysis which, says Dr. Jacob
Warman, chief of endocrinology at the Brooklyn Hospital Center in
New York City, "doesn't prove anything." These types of analyses
tend to be more "hypothesis-generating." (When researchers conduct
a meta-analysis, they synthesize previous studies to look for
patterns that would not show up in an individual study).
"It's suggestive but I don't know that it's conclusive," added Dr. Steven D. Wittlin, clinical director of the diabetes service at the University of Rochester Medical Center in Rochester, N.Y.
While there was a benefit seen in macrovascular complications,
such as heart attacks, it's unclear if the same would be true with
microvascular complications or those that involve small blood
vessels and contribute to conditions such as neuropathy, Wittlin
That could change the risk-benefit ratio, he noted.
Also, as the authors themselves pointed out, the biological
mechanisms behind the effect are still not clearly understood.
The U.S. Food and Drug Administration has more on
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