Never too late to start statins for clogged leg arteries: Study

Washington: Statins, a class of drugs that reduce illness and mortality in those who are at high risk of cardiovascular disease can also prove effective for those with the peripheral arterial disease even if they start its medication late after diagnosis.

According to the study presented today at the ‘ESC Congress 2019’ patients who stop the drug are at similar risk to those who never start. The research showed the importance of starting and adhering to lifelong medication, preferably at a high dose.

Around 200 million people worldwide have peripheral arterial disease (PAD), a condition in which arteries in the legs are clogged. This restricts blood flow to the legs and raises the chances of stroke and heart attack.

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Around 30 per cent of patients have pain and cramping in their legs when they walk – referred to as intermittent claudication – while others have gangrene in the feet due to poor circulation.

Statins are recommended for all patients with PAD, together with smoking cessation, exercise, healthy diet, and weight loss.

Statins diminish the risk of stroke and heart attack by reducing low-density lipoprotein (LDL) cholesterol, which causes blocked arteries (atherosclerosis).

“The study shows that adherence to statins is essential for the best prognosis. We also show that it is never too late to start medication and benefit from it. On top of that, it is crucial not to reduce the dose because LDL cholesterol levels rise again, thus increasing the overall risk on top of the residual risk for further events,” said Dr Jorn Dopheide of Bern University Hospital, Switzerland.

The study examined whether adherence to statin therapy influenced survival in patients with symptomatic PAD. The study enrolled 691 patients admitted to hospital between 2010 and 2017 and followed-up for a median of 50 months.

At the beginning of the study, 73 per cent of patients were on statins, increasing to 81 per cent at the 50-month follow-up. The dose of drug also increased between the two time periods, which was paralleled by a significant drop in LDL cholesterol from 97 to 82 mg/dL.

Patients who stopped taking a statin had a similar mortality rate (33 per cent) to those who never took the drug (34 per cent). Adhering to statins throughout the 50 months was linked with a 20 per cent rate of death.

Taking high-dose statins throughout the study was linked with the lowest mortality rate (10 per cent) while reducing the dosage during the study was related to the highest death rate (43 per cent).

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