Cholesterol Drug May Help Clogged Arteries

A drug used to lower cholesterol in the blood is also proving to be effective in reversing atherosclerosis. A study published in a recent issue of the Journal of the American Medical Association showed how cardiologists at Johns Hopkins used the cholesterol-lowering drug, rosuvastatin (Crestor) to reverse the fatal risks of atherosclerosis.

Atherosclerosis (ath’er-o-skleh-RO'sis) occurs when the lining of an artery becomes covered with a buildup of plaque, eventually narrowing the artery and reducing the blood flow. Plaque consists of fatty substances, cholesterol, cellular waste products, calcium and other substances which cause the artery to harden.

Everyone has some hardening of the arteries as they age but the real danger is when the artery gets fragile from plaque buildup and then ruptures, forming blood clots which can break off and travel to another part of the body. When the clot blocks a blood vessel, the result can be a heart attack or stroke. According to the American Heart Association, nearly three-quarters of all deaths from cardiovascular disease are due to atherosclerosis.

“The study results are very exciting and bound to stir debate and further research,” said cardiologist Roger S. Blumenthal, an associate professor and director of the Ciccarone Preventive Cardiology Center at Johns Hopkins and lead author of the editorial. “Until now, many scientists did not believe that atherosclerosis could be reversed, even modestly, in people.”

The two-year study was conducted primarily at the Cleveland Clinic and included more than 500 men and women with mild to moderate atherosclerosis. Each participant received a high-intensity dose of 40 milligrams a day of rosuvastatin, (brand name Crestor) instead of the usual dosage of 10 milligrams a day. Intravascular ultrasound (IVUS) imaging (a technique where a tiny ultrasound probe is inserted into the artery to measure the plaque) was used to measure the degree to which arteries were clogged both before and after treatment. Researchers also used blood chemistry testing to measure the LDL (bad cholesterol levels). Nearly all the patients experienced an average 53 percent decline in their LDL levels while their HDL (good cholesterol) levels were boosted by 15 percent. The overall progression of their atherosclerosis was slowed down by an average of 14 percent.

While the results are impressive, the scientists involved are calling for more research. “Our next steps have to determine whether these very promising results translate into greater reductions in future heart attacks and strokes,” said editorial co-author Navin K. Kapur, a clinical research fellow at Johns Hopkins. Blumenthal also cautioned that the study's results would have been more convincing if the authors had compared the intense cholesterol-lowering treatment to a more moderate treatment, such as simvastatin (Zocor).

The next step in the study will be to examine results from other ongoing clinical trials that are comparing the effects of different dosages and levels of cholesterol treatments. “The results certainly support the idea that we should be even more aggressive in our cholesterol management of people with at least moderate atherosclerosis,” Blumenthal said.

The study itself has received some criticism since it didn’t include patients taking a placebo pill and was funded by AstraZeneca, which produces Crestor. The drug has also come under fire in Europe and Canada for its potentially serious side effects that include kidney failure (rhabdomyolysis). The U.S. consumer watchdog group Public Citizen (founded by Ralph Nader) wants Crestor to be taken off the market because it believes that the risks for side effects like rhabdomyolysis and muscle wasting are too high, particularly when the dosage is higher than the recommended 20 milligrams per day.