Statins, yes; antioxidants, no

From Anaheim, Calif., at the American Heart Association’s Scientific Sessions 2001.

In people who are at risk of heart attack or stroke, drugs known as statins can significantly reduce the likelihood of a life-threatening episode even when the person isn’t an obvious candidate to receive the cholesterol-lowering treatment, researchers report. The finding could expand greatly the number of people getting statins.

Starting in the mid-1990s, British scientists gave half of 20,536 people, ages 40 to 80, the drug simvastatin, which is also called Zocor. The rest received an inert pill. Half of each group also took antioxidants–beta carotene and vitamins C and E–while the others got inert pills in place of the antioxidants.

The participants were at increased risk of heart or other vascular problems because they all had a history of diabetes, stroke, or cardiac disease such as angina or heart attack. All had marginal cholesterol concentrations that their physicians were unsure warranted use of statins.

Nevertheless, after 5 years, those getting simvastatin experienced one-third fewer heart attacks, strokes, and other vascular problems than those getting placebos did, says Rory Collins of the University of Oxford.

“We found these benefits in these high-risk individuals irrespective of their cholesterol levels,” he says. The vitamins, however, had no effect on vascular-disease risk in this trial. Antioxidants have yielded mixed results in recent studies of their effect on vascular disease.

Physicians are often uncertain whether to prescribe a statin for people with marginally high cholesterol. About 25 million people currently take statins.

If 10 million additional people similar to the participants in this study started taking the drugs, “that would save 50,000 lives a year,” Collins predicts.