Statins - could 7% of people have INCREASED risk of heart attack? - June 2004

Statins are not "wonder drugs" for all

• 21:00 15 June 2004

The cholesterol-lowering "wonder" drugs known as statins may be less wondrous for people with two genetic variations, reveals a new study.

Nearly seven per cent of the population have genetic features which make statins an average of 20 per cent less effective at lowering cholesterol levels, found Daniel Chasman of Harvard Medical School in Boston, US and his colleagues.

The researchers now plan to study whether those seven per cent of statin takers end up having more heart attacks and cardiovascular disease due to their weak response to the drug.

Statins are the most potent and popular cholesterol fighting drugs. They work by clogging a protein enzyme called HMG-CoA reductase which helps manufacture cholesterol. While at least ten proteins are known to influence the metabolism of cholesterol, Chasman's team wanted to test if naturally occurring variations in the genes that encode these proteins also influence the effectiveness of statin therapy.

They studied DNA from 1536 volunteers who took a statin called pravastatin during a 24-week trial. The researchers analysed the DNA for single polynucleotide polymorphisms (SNPs), DNA sequences which are used to track genetic differences between people.

In patients with two particular SNPs, both located in the gene for HMG-CoA reductase, statins were 20 per cent less effective at lowering total cholesterol and low-density lipoprotein, also known as "bad" cholesterol.

Journal reference: Journal of the American Medical Association (vol 291, p 2821)