Statins for all men over 55?

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Statin medications such as Lipitor and Crestor are a cost-effective way of preventing heart attacks even in lower-risk populations, according to a computerized analysis published this week in Circulation. The study suggests current guidelines should be expanded and that it’s cost-effective for all men to take statins starting at age 55. Men with one risk factor, such as hypertension, could start using the drugs at age 50, while men with two or more risk factors could begin at age 40. The study indicates this would be a more cost-effective strategy than screening patients based on whether they had high levels of C-reactive protein, a sign of inflammation and potentially higher risk of heart attack.

But lead study author Dr. Keane Lee of the Stanford University School of Medicine acknowledges that his team’s cost-benefit analysis has its limits. It assumes that the drugs are inexpensive and have no long-term adverse effects. Even if people simply dislike having to take a pill once a day, that would count against their cost-effectiveness, Dr. Lee says.

Still, ACSH’s Dr. Elizabeth Whelan says the study shows the drugs should be more widely prescribed. “Using pharmaceuticals, even expensive ones, is usually much less expensive than being in the hospital — and that’s what we’re talking about here with statins. Fortunately, statins are among the safest of medications, and generic versions are inexpensive.”

Statins may even retard the growth of prostate cancer, a preliminary study published in the September issue of European Urology suggests. Canadian researchers implanted human prostate cancer cells into mice and found treatment with rosuvastatin (Crestor) seemed to suppress the cancer’s growth. Another study published in June in Cancer found that men taking statins while undergoing surgery to treat prostate cancer had a lower rate of recurrence than those who didn’t take the drugs.

ACSH’s Dr. Gilbert Ross says to not jump the gun based on these reports. “The recent Canadian study of prostate cancer and statins involved mice, and the older study on prostate cancer surgery and statins was not controlled, but retrospective. Nevertheless, statins have been shown to have beneficial impacts on numerous diseases, and no one knows exactly why. One theory is that statins reduce inflammation and may have other physiologic effects that we have not yet elucidated. This drug class has vast potential to improve health outcomes, but much more research is needed.”