HOUSTON – About one-in-four adults ages 40 and older take a cholesterol-lowering statin. These medications have been game changers for people with high cholesterol.
Research shows statins can reduce the risk of heart attack, stroke and death in high-risk patients, but adding another drug to the mix might offer even bigger benefits.
Sixty-one-year-old Carol Hrvatin has been battling high cholesterol for years.
"Probably in my 40s, I started noticing I had some high cholesterol," Hrvatin said.
The retired schoolteacher had a heart attack six years ago. Hrvatin now takes Repatha, an injectable medicine to lower her cholesterol. A new study found that using this drug along with a statin can significantly lower LDL, or bad cholesterol levels.
"To a level that has not really been achieved in any substantial clinical trial," cardiologist Dr. Steve Nissen said.
Researchers studied 968 patients. Some took a statin, and some took a statin plus Repatha. After 18 months, the statin-only group had an average LDL of 93. Those who took both medicines averaged an LDL of 36, the lowest level ever observed in a clinical study.
The statin patients had no change in the amount of plaque in their coronary arteries, but 64 percent of patients who took both drugs had less plaque. Those with the lowest LDL levels had the most significant improvement.
"You know, we used to say, 'You can't be too rich or too thin.' We now say, 'You can't be too rich, too thin or have too low of a cholesterol level,'" Nissen said.
The study could lead to new guidelines pushing for lower cholesterol levels. Hrvatin's LDL levels went from 137 before Repatha to 65 after treatment.
Right now, even the strictest guidelines suggest LDL levels should be 70 or less, but Nissen said the study could lead to much lower recommendations.
The researchers said there were no safety issues associated with the extremely-low cholesterol levels they observed in the study. Repatha is typically injected once or twice a month.