Statins are widely used as the most effective medications we have to lower cholesterol. And recent research shows that statins also reduce the size of atherosclerotic plaques, a risk factor for heart disease. Now, a study suggests even more benefits from statins in people with heart failure.
Until now there has been little information on the effects of statins in people with heart failure because they have been excluded from statin trials. The new study, published recently in the Journal of the American Medical Association, is the first time these medications have been studied in people with chronic heart failure.
The authors looked at nearly 25,000 patients who had never taken a stain drug before. Over the next eight years, they compared the 51 percent of participants who started taking a stain with those who did not. Those who took a statin had a 24 percent lower death rate and a 21 percent lower rate of hospitalization for heart failure compared to those who chose not to take a statin. These benefits of statins occurred regardless of age or gender, or whether heart failure was due to coronary artery disease.
I agree with the authors' conclusions that these benefits of statin therapy were probably due to other recognized effects of statins rather than to lower LDL cholesterol levels. It is possible that the statins prevented heart failure from worsening by stimulating the formation of new blood vessels, by reducing the amount of inflammation, by improving the function of the endothelial cells that line the walls of arteries, or by stabilizing atherosclerotic plaques in the coronary arteries to prevent plaque rupture and clot formation.
As the authors state, these findings are not definitive because they are based on observational studies and need to be verified in a randomized clinical trial. Observational trials can only show associations. A prospective, randomized trial is the only way to determine whether an intervention actually improves outcomes.