Intensive statin use reduces heart risks further

* Analysis of 26 trials could boost use of statins

* Even patients with low cholesterol can benefit further

* Findings could change prescribing habits

LONDON, Nov 9 (Reuters) - Treating patients more intensively with statin drugs to safely lower cholesterol can lead to even greater reductions in the risk of heart attacks and strokes than giving standard doses, scientists said on Tuesday.

In research that could further boost the market for statins like AstraZeneca's AZN.L Crestor and Pfizer's PFE.N Lipitor, scientists said the benefit achieved is directly proportional to the reduction in low-density lipoprotein (LDL) cholesterol, even in patients with already low levels.

“It is a continuous relationship right the way down to very low levels of LDL cholesterol,” said Colin Baigent of Oxford University, Britain, who led the study with other scientists from University of Sydney, Australia.

Statins, the world’s top-selling drugs, have been so effective at lowering LDL or so-called “bad cholesterol” they have been credited with preventing millions of heart attacks and strokes. Some doctors have joked they should be added to the public water supply.

In a commentary, Bernard Cheung and Karen Lam of the University of Hong Kong, who were not involved in the research, said “at the population level, statins are underused.

“The urgent priority is to identify people who would benefit most from statin therapy and to lower their LDL cholesterol aggressively, with the more potent statins if necessary,” they wrote in The Lancet, where the research was also published.

Baigent and scientists from the Cholesterol Treatment Trialists’ (CTT) Collaboration conducted a review of 26 statin trials called a meta-analysis and which covered 170,000 people.

Of these, five trials compared intensive statin treatment with regular statin treatment, and the other 21 studies compared the effects of taking statins versus not taking statins.

When analysing the combined results of the five intensive trials, the scientists found that compared with less intensive treatment, more intensive treatment produced a “highly significant” 15 percent further drop in major vascular problems.

This included a 13 percent cut in heart-related death or non-fatal heart attack, a 19 percent cut in patients needing bypass or other coronary treatments, and a 16 percent reduction in strokes, they reported in their study.

Taking all 26 trials together, deaths from all causes were reduced by 10 percent for every 1.0 millimole per litre (mmol/L) reduction in LDL cholesterol, reflecting declines of 20 percent in deaths due to coronary heart disease and 11 percent in other cardiac-related deaths, the researchers said.

The scientists found no significant effects on deaths due to stroke or other vascular causes, or on deaths due to cancer or other non-vascular causes, and said there was also no evidence of any excess risk of cancer -- a risk some researchers had previously suggested could be linked with taking LDL cholesterol down to very low levels.

Jeremy Pearson of the British Heart Foundation, which part-funded the study, said its findings may change the way doctors were advised to prescribe statins, and would give them “another tool for helping people keep their hearts healthy”.

Many statin brands such as Merck & Co's MRK.N Zocor, are now generic, and many more will soon go off patent, making the drugs even more affordable. (Editing by Dan Lalor)