Drug reduces risk of elderly dying of heart disease

A LANDMARK clinical trial has confirmed for the first time that older people can reduce the risk of dying from heart disease by 24% by using the cholestrol-lowering medicine pravastatin.

The international trial, carried out over three years in centres in Ireland, Scotland and the Netherlands, also found that pravastatin reduced the risk of heart attack and stroke by 19%.

Of 5,804 people aged between 70 and 82 (2,184 people in Ireland), half were given pravastatin and the other half were given a placebo or sugar pill. There were 25% fewer deaths in the pravastatin-using group.

University College Cork-based study director Dr Brendan Buckley said the trial results showed for the first time the value of treating people over the age of 70.

“Currently in the 70-82-year-old age group, only approximately one-third are given appropriate treatment for preventing the next heart attack or stroke. Doctors in general haven’t known if it’s worthwhile treating this age bracket because a lack of evidence of its effectiveness. This study is evidence-based.”

Dr Buckley said the huge scope of the trial (it involved the screening of 23,769 people) was made possible by the provision of an unrestricted 50m-plus grant to the three participating universities of UCC, the University of Glasgow and the University of Leiden. It was sponsored by the Pharmaceutical Research Institute of Bristol-Myers Squibb Company, but Dr Buckley said the universities had approached the drug companies for funding and that there was no question of the study being anything but independent.

He said the findings of the study were particularly relevant given that cardiovascular disease is the biggest killer among the elderly and because of a growing aging population.

Results of PROSPER (Prospective Study of Pravastatin in Elderly at Risk) were presented yesterday in Chicago at the American Heart Association congress by Professor Michael Murphy. They are due for publication in this month’s issue of medical journal the Lancet.

The benefits of cholesterol-lowering drugs, or statins, to reduce heart attack and stroke in younger and middle-aged people are already well knownProfessor Murphy said: “PROSPER is good news for our senior citizens. The results tell us for the first time that we should not discriminate between older and middle-aged people when we select patients for therapy to prevent heart attack.

“Older people currently represent the largest group of under-treated individuals in our community.”

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