Statins, Cholesterol, and Coronary Heart Disease

Statins – Lescol^TM, Lipitor^TM, Mevacor^TM, Pravacol^TM, and Zocor^TM – are the most widely used prescription drugs in the world. Over 20 million people worldwide take statins, and the resulting annual sales exceeded 16 billion dollars in 2001.2 Why are they so popular? People take statins to lower their cholesterol. Indeed, these drugs can reduce blood serum cholesterol levels by 30 to 40% or more.

As described in the previous chapter, experts have found that the incidence of coronary heart disease (CHD) is essentially the same for people with elevated and normal blood serum cholesterol levels. The Cholesterol Risk Characterization Theaters (RCTs) shown in Chap. 8 suggest that the level of benefit from reducing cholesterol levels may not support the contention that cholesterol is a primary risk factor for CHD. Yet many of the people who take statins to lower their cholesterol do so in the hopes of reducing their risk of heart disease. Two key questions arise. Do individuals taking statins have a lower incidence of CHD when compared to individuals not taking these drugs? If so, are the benefits due to lowering blood serum cholesterol levels, or are they due to something else?