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People at 'Intermediate Risk' of Heart Disease With Elevated hsCRP Benefit From Statin Therapy Even if Cholesterol Levels are Normal
Date:8/24/2010

istically significant reduction in events with statins.

He said recent changes in Canadian prevention guidelines prompted a need to better define CVD risk. The new Canadian recommendations call for statin therapy for patients who have "intermediate risk" – defined as 10 percent to 19 percent 10-year risk – and elevated hsCRP, even if their cholesterol levels are in the normal range (i.e. LDL-cholesterol below 130 mg/dL).

"The new Canadian guidelines are a major step forward for prevention and incorporate hsCRP in a thoughtful manner," Ridker said. "However, intermediate risk was defined in the Canadian guidelines as 10 to 20 percent 10-year risk, yet we observed major benefits of statin therapy for those with risks of 5 to 10 percent as well." He added that many physicians incorrectly consider a 5 percent to 10 percent risk score to be "low-risk," especially in woman who tend to develop CVD at least a decade later than men, although heart and blood vessel disease remains the number one killer of women and men.

Risk is calculated with screening tools, such as the Framingham Risk Score, which predicts CVD risk based on traditional risk factors such as age, gender, smoking, blood pressure and cholesterol; or the Reynolds Risk Score which also considers hsCRP and parental history of premature heart disease.

The current study finds that although men and women in the 5 percent to 10 percent Framingham 10-year risk group get equal benefit from statin therapy, more women tend to be in the 5 percent to 10 percent risk group while men tend to be in the 11 to 20 percent group.

"The current U.S. recommendations label individuals with a greater than 20 percent 10-year Framingham risk as high risk and advise statin therapy for them. Statin treatment for individuals with Framingham risk under 20 percent has until now been less clear-cut."

These data also support the current position taken by the American Heart Association and
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SOURCE American Heart Association
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