Statins found to work better in studies than in practice

Drugs are very effective in research settings, but experts say a lack of compliance with regimens is the leading barrier to lowering cholesterol populationwide.

By Victoria Stagg Elliott, AMNews staff. Dec. 10, 2001.

An increasing body of evidence is showing that statins should be prescribed to an ever growing number of people.

A study presented at last month's annual Scientific Sessions of the American Heart Assn. found that statins could benefit those who were at high risk of heart disease, including those with diabetes, but had normal cholesterol.

Meanwhile, in May, the National Heart, Lung and Blood Institute's National Cholesterol Education Program issued guidelines substantially expanding the number of people who should be prescribed statins from 13 million to 36 million.

"If patients take them, you should see up to a 30% reduction in cholesterol levels," said Helene Glassberg, MD, director of the preventive cardiology and lipids center at Temple University Hospital in Philadelphia.

But that's a big if. Physicians say that 90% of their patients prescribed statins should benefit from the drug. They also estimate, however, that they can get only as many as 70% of their patients to stick to a statin regimen after a cardiac event. That number plummets to 30% for patients who have high cholesterol but have not had heart trouble.

"The guidelines are way ahead of what people are really doing," said Dennis Sprecher, MD, section head of preventive cardiology and rehabilitation at the Cleveland Clinic. He researches patient compliance issues.

According to a study by Dr. Sprecher also presented at the heart association conference, only one-third of patients in a clinical setting achieved their cholesterol goals three months after being prescribed a statin. Nearly half achieved some reduction but did not meet their goals, and 18% experienced no reduction or an increase in their cholesterol levels. [...]