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Heart Beat: Statins may need a boost in blacks

Heart Beat

Statins may need a boost in blacks

Cholesterol-lowering statins generally do a good job of knocking down levels of LDL (bad) cholesterol. As with any drug, though, individual responses range from superb to subpar. They depend on how faithfully a person takes the drug, how well it is absorbed, and how the body handles it. Genes certainly affect the end result. A study suggests that race may, too.

Researchers looked at changes in cholesterol levels in more than 16,000 members of a Midwestern HMO who were newly diagnosed with high cholesterol and who were prescribed a statin for getting it under control. The statins include lovastatin (Mevacor, generic), pravastatin (Pravachol, generic), simvastatin (Zocor, generic), atorvastatin (Lipitor), and rosuvastatin (Crestor).

After one year, 71% of whites and 49% of blacks had reached their target LDL levels. The researchers traced some of the difference to the fact that black HMO members had slightly higher starting LDL levels. They also didn't take the medicine as regularly as whites and had fewer follow-up cholesterol tests. But even when the researchers focused only on people who stuck with their medication and had routine checkups, blacks were still more likely than whites to have had higher LDL after a year's worth of statin therapy.

Many factors influence LDL levels, from diet and exercise to stress and socioeconomic status. Any of these could contribute to a difference in LDL levels despite similar treatment strategies. It is also possible that statins just aren't as effective at lowering LDL in blacks as they are in whites, the researchers suggest in the October American Heart Journal. Adding another cholesterol-lowering drug to statin therapy may help. Possible additions include niacin or a cholesterol blocker, such as colesevelam (WelChol) or ezetimibe (Zetia).

Last updated:	September 05, 2008