Should we all take cholesterol-lowering drugs?

Eat healthy, perform physical activities and ...take your statin. This will perhaps one day the official message of public health to prevent heart attacks, strokes and other cardio-vascular.

In fact, statins are not only for cholesterol treatments. Over the years, these drugs assert themselves more and more as a means of preventing cardio-vascular, including now in people with normal cholesterol levels.

In the U.S., earlier this week, the Federal Drug Agency (FDA) has extended the indications of Crestor, a statin drug marketed by AstraZeneca. This medication may be prescribed to prevent individuals without cardiovascular disease or apparent high LDL cholesterol, but considered at risk for cardiovascular disease.

As evidence of this excess risk, three parameters were selected: age (50 years and more men, 60 women) and the high rate of a marker of cardiac risk, high-sensitivity CRP in the blood and the presence of another risk factor for cardiovascular disease, including hypertension, smoking or family history of heart disease.

These criteria correspond largely to those used in a large study (called Jupiter) published in late 2008, in which Crestor was reduced by 44% the cardio-vascular and 20% mortality compared to placebo. This extension of indication (including other manufacturers of statins could indirectly benefit) is far from anecdotal.

In the United States the population eligible for these treatments could be 16-17 million people, say experts. With a potential profit of several billion for AstraZeneca, maker of Crestor. And the phenomenon could reach Europe in the coming months. AstraZeneca has also filed an application for extension of its statin indications to European Medicines Agency.

The main difference with the United States: the target population would be defined by age and the presence of two vascular risk factors, but not by CRP ultrasensitive. Indeed, the sensitivity CRP is a marker of advanced cardiovascular risk, but it is rarely used in practice.

Do not forget that changes in lifestyle, exercise and diet may also help reduce cardiovascular mortality. And at a lower cost to society.

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