Statins Benefit Patients at Risk for Coronary Disease, Even When Cholesterol Levels Are Normal

In the partly industry-funded Heart Protection Study, 20,536 British patients (75% male; age range, 40 to 80) with total cholesterol levels of at least 135 mg/dL (3.5 mmol/L) were randomized to receive simvastatin (40 mg daily) or placebo for 5 years. Enrollment criteria were histories of coronary disease, other occlusive arterial diseases, diabetes, or (in men aged 65 or older) treated hypertension.

Five-year all-cause mortality was significantly lower in the simvastatin group than in the placebo group (12.9% vs. 14.7%) -- a difference attributable mainly to a significantly lower coronary death rate. The simvastatin group also experienced significant reductions in nonfatal myocardial infarction (3.5% vs. 5.6%) and nonfatal stroke (3.6% vs. …