NIH Study Questions Treatment for Heart Disease
Recent studies have shown that coffee, rather than being harmful to your health, can reduce the risk of some types of cancer. Another recent study calls into question treating heart disease by using using a medication that raises good cholesterol in conjunction with one that lowers the bad. A National Institutes of Health study published on Thursday reports that taking the bad cholesterol-lowering statin simvastatin — also known under the brand name Zocor — in tandem with high dosages of Abbott Laboratories’ Niaspan did not prevent heart attacks and actually raised the likelihood of a stroke.
Yes, not exactly the results people seeking to lower their bad cholesterol and risk of heart disease were wanting to hear.
In the NIH study, 3,414 participants with heart and vascular disease were given 40 milligrams of Zocor and a placebo, or 40 milligrams of Zocor and Niaspan, which is an extended release form of niacin, a vitamin found to raise cholesterol. The participants were to be followed for 32 months but researchers ended the trial 18 months early after finding “there was almost no chance taking Niaspan would prove beneficial,” says the New York Times. Taking the Zocor (and other medications) did help to keep participants’ bad cholesterol levels relatively low.
Prior to the NIH study, Abbott Laboratories — which had $927 million in Niaspan sales last year — had said that there had been “no stroke safety signals in any clinical trials or post-marketing safety data.”
In view of the study’s results, the Food and Drug Administration says that it is making “no new conclusions or recommendations regarding the use of niacin alone or in combination with simvastatin or other statins.” Researchers noted that patients should not stop taking Niaspan without talking to their doctors first.
Nonetheless, the NIH analysis has the potential to change how doctors treat heart disease as the New York Times notes:
Common wisdom has been that … patients should take a statin drug like Lipitor or Zocor to lower bad cholesterol and, in many cases, the vitamin niacin to raise their good cholesterol. But in the trial, niacin provided no benefit over simple statin therapy.
The results are part of a string of studies that suggest that what doctors thought they knew about cholesterol may be wrong. Studies that track patients over time have for decades shown that patients with higher levels of high-density lipoproteins (H.D.L., or good cholesterol) tend to live longer and have fewer heart problems than those with lower levels of this cholesterol.
Not surprisingly, doctors thought that if they could raise H.D.L. levels, their patients would benefit. So far, that assumption is not panning out. Nobody knows why.
The Los Angeles Times emphasizes that:
The study doesn’t question the conventional wisdom that raising HDL (good cholesterol) can reduce cardiovascular risk. Rather, it focused on the effects of using medication to simultaneously raise those levels while bringing down LDL levels. But given the unexpected results, some analysts expect more studies on the benefits of HDL.
An estimated 1 in 7 Americans have high cholesterol, the Los Angeles Times notes; the NIH calls high cholesterol a major risk factor for cardiovascular disease, which kills 800,000 people in the U.S. each year.
One has to wonder a bit, though, about what results the next study about heart disease and cholesterol might tell us.
Photo by sylvar.