A study published in a 2007 issue of the Annals of Internal Medicine suggested that taking higher doses of atorvastatin (Lipitor) may reduce the incidence of cardiovascular events, such as heart attack or stroke.
The study, labeled Treating New Targets (TNT), looked at roughly 10,000 older adults that already had cardiovascular disease and had an average low-density lipoprotein (LDL,) level of 162 mg/dL, which is higher than the recommended level of below 100 mg/dL. These participants were randomly assigned to take 10 mg or 80 mg of atorvastatin (Lipitor) a day. As a result, participants taking atorvastatin (Lipitor) 80 mg reduced their LDL cholesterol from an average of 163 mg/dL to 72 mg/dL while participants taking atorvastatin (Lipitor) 10 mg reduced their LDL cholesterol from an average of 163 mg/dL to 97 mg/dL. High-density lipoproteins (HDL) did not appear to be affected. The participants who took 80 mg of atorvastatin (Lipitor) also had a 2.3-percent lower risk of experiencing fatal or non-fatal cardiovascular events compared to the participants who took 10 mg. Additionally, participants that were 65 years of age or older receiving atorvastatin (Lipitor) 80 mg had a reduced risk of cardiovascular events that was equivalent to a participant younger than 65 years of age receiving 10 mg. The investigators in the study also noted that atorvastatin (Lipitor) was well-tolerated. Despite the high dose of atorvastatin (Lipitor) given to these patients, the side effects from patients taking 10 mg versus 80 mg appeared to be equal.
Does this mean that higher doses of a statin, such as atorvastatin (Lipitor), is good? Not necessarily. Although this study did show a definite correlation between taking high-dose atorvastatin (Lipitor) and the reduced likelihood of death from corornary artery disease, especially in older adults, more research would be needed to establish whether it is the reduced cholesterol levels, high amounts of atorvastatin, or both that play a role in the reduction of cardiovascular events. Additionally, this study was funded by Pfizer, which could be seen as a conflict of interest in this study. Pfizer is the maker of atorvastatin (Lipitor) and is set to lose their patent on the drug in 2010. In any case, this study does show the powerful ability that statins possess in reducing cholesterol and their role in reducing the consequences of heart disease.
Sources:
Wenger NK, Lewis SJ, Herrington DM et al. Outcomes of Using High- or Low-Dose Atorvastatin in Patients 65 Years of Age or Older with Stable Coronary Heart Disease. Ann Intern Med. 2007;147:1-9.
