Researchers studied mortality over a 20-year period in more than 5,500 men aged 45-64 with either ‘very high’ or ‘elevated’ LDL levels and no initial sign of heart disease. They were given 40mg of pravastatin daily.
They found that giving pravastatin to men with ‘very high’ LDL – above 190mg/dL – reduced 20-year mortality rates by 18%, reduced the risk of death from coronary heart disease by 28% and the risk of death by other CVD by 25%.
Treatment with pravastatin could also translate into ‘large mortality benefits’ for patients with lower ‘elevated’ LDL levels – between 155 and 190mg/dL – they added.
These findings, published in Circulation, challenge the current ‘wait and see’ approach used on younger patients with LDL elevation, they said, warning that even they are at higher long-term risk of heart disease.
Senior author Professor Kausik Ray, from Imperial College London, said: ‘For the first time, we show that statins reduce the risk of death in this specific group of people who appear largely healthy except for very high LDL levels. This legitimises current guidelines which recommend treating this population with statins.
‘Our findings provide the first trial-based evidence to support the guidelines for treating patients with LDL above 190mg/dL and no signs of heart disease. They also suggest that we should consider prescribing statins more readily for those with elevated cholesterol levels above 155 mg/dl and who also appear otherwise healthy.
‘This is the strongest evidence yet that statins reduce the risk of heart disease and death in men with high LDL. Our study lends support to LDL's status as a major driver of heart disease risk, and suggests that even modest LDL reductions might offer significant mortality benefits in the long-term.’