In a significant push for cardiovascular health, researchers from Florida Atlantic University’s Schmidt College of Medicine have published an editorial in Trends in Cardiovascular Medicine advocating for the use of high-potency statins. The editorial highlights the importance of lowering LDL cholesterol levels to treat and prevent cardiovascular disease, a leading cause of death globally.
Often referred to as “bad” cholesterol, elevated LDL levels can lead to clogged arteries, increasing the risk of heart attacks and strokes. The FAU researchers recommend starting treatment with the highest doses of potent statins such as rosuvastatin and atorvastatin, alongside therapeutic lifestyle changes.
Therapeutic Lifestyle Changes: A Cornerstone of Prevention
The researchers emphasize that lifestyle modifications are crucial both with and without adjunctive therapies. Key lifestyle changes include quitting smoking, maintaining a healthy weight and blood pressure, engaging in regular physical activity, and limiting alcohol intake. Despite these proven benefits, approximately 40% of U.S. adults suffer from metabolic syndrome, a cluster of risk factors that elevate cardiovascular risk.
Dr. Charles H. Hennekens, the senior author, notes that only 21% of Americans meet the minimum daily physical activity requirements. He stresses that increasing activity is beneficial at any age, even for older adults.
Statins: The Evidence and Recommendations
Based on extensive randomized trial data and meta-analyses, the FAU team concludes that statins, particularly rosuvastatin and atorvastatin, have the most robust evidence supporting their use in cardiovascular treatment and prevention. They recommend that cardiologists start with the highest statin doses and adjust as necessary, noting that the combination of statins and aspirin can be particularly effective.
“Practicing cardiologists may wish to consider that all adjunctive drug therapies to therapeutic lifestyle changes should be added only after achieving maximal doses of statins,” said Dr. Hennekens.
The authors caution against overuse of adjunctive therapies like ezetimibe and evolocumab, suggesting they be reserved for high-risk patients not meeting LDL goals with statins alone. The IMPROVE-IT and FOURIER trials provide context for these recommendations, showing limited benefits when these drugs are added to statin therapy.
Omega-3 Fatty Acids and Emerging Therapies
The role of omega-3 fatty acids in cardiovascular health has been debated. Early trials were promising, but later studies showed mixed results, possibly due to widespread statin use. However, the REDUCE-IT trial demonstrated significant benefits of icosapent ethyl, a purified omega-3, when combined with high-potency statins, reducing major cardiovascular events by 25%.
Dr. Hennekens reflects on the enduring wisdom of Benjamin Franklin’s adage that “an ounce of prevention is worth a pound of cure,” underscoring the importance of proactive health measures.
About the Charles E. Schmidt College of Medicine
Florida Atlantic University’s Charles E. Schmidt College of Medicine, established in 2010, is a leader in medical education and research. With a focus on innovative curriculum and hands-on learning, the college prepares graduates for diverse careers in medicine and research. It offers various graduate programs and manages the FAU Medical Group, providing comprehensive care and specialized services.
The college’s consortium for graduate medical education, formed in partnership with leading hospitals, ensures a well-trained physician workforce in Palm Beach County. This collaboration supports residencies and fellowships across multiple specialties, enhancing the region’s healthcare landscape.
As the medical community continues to explore and refine cardiovascular treatments, the recommendations from FAU’s experts highlight the critical role of high-potency statins and lifestyle changes in combating heart disease. The ongoing research and dialogue promise to shape future strategies for heart health.
