Every year, half of all heart attacks and strokes occur in people who appear to be healthy with no signs of cardiac problems. A landmark study, released Sunday at the American Heart Association meeting, shows how to dramatically reduce those risks.
It suggests that statins, popular drugs used to lower cholesterol, could also help millions of Americans who already have low cholesterol by reducing their risk of heart attack and stroke.
"This is perhaps the most important study in the last decade in terms of reducing risk of heart disease," said Dr. Daniel Rader, of the University of Pennsylvania School of Medicine.
This study followed nearly 18,000 people: men 50 and older and women 60 and over. Blood tests revealed that all had low to healthy levels of cholesterol, but high levels of C-reactive protein, a sign of inflammation in the body.
Inflammation poses a serious problem because it causes plaque in the walls of arteries to become unstable and more likely to rupture, resulting in a sudden blood clot and heart attack.
In the study, half of the volunteers were given 20 mg of Crestor, the newest and most potent statin drug, though all statins lower cholesterol and inflammation. The study was sponsored by AstraZeneca, the maker of Crestor.
The results, published in the New England Journal of Medicine, revealed that among those taking Crestor, the rate of heart attacks fell by 54 percent, the rate of strokes went down by 48 percent and cases of death were reduced by 20 percent, compared with those getting a placebo.
"The reductions in heart attack and stroke are bigger than anything we've ever seen," said Dr. Christopher Cannon of Brigham and Women's Hospital.
The benefits were so overwhelming that the five-year study was stopped after less than two years.
Many doctors predict this one study will dramatically change the practice of medicine by prompting millions of healthy Americans, middle-aged and older, to now get tested for C-reactive protein. If they find that the levels are high, they'll likely go on a statin drug.
While the drugs reduced the rate of heart attacks, there are associated risks from these medications. Some patients experienced muscle pains, and in this study, there was a slight increase in the risk of diabetes. Long-term risks remain unknown.
Still, the goal of studies like these is to avoid what happened to 64-year-old Jerry Thornell, of Marion, Mass. Thornell thought he was doing everything right. He exercised regularly, ate nutritiously and kept his weight and cholesterol levels low. Then, four years ago, without warning, he had a heart attack.
"I was very surprised," Thornell said. "I just didn't see myself as a cardiac event waiting to happen."
Thornell's only risk factor, it turned out, was high inflammation. "That's what I wasn't doing right," he said. "I wasn't paying any attention to it."
He is now. Thornell now takes a daily statin, which has cut his inflammation levels by more than half.