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Outcomes of Drugs and Vitamins in Treating Heart Disease

By HospiMedica staff writers
Posted on 05 Dec 2001
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A study has demonstrated that treatment with a combination of statin and niacin can slash the risk of a fatal or nonfatal heart attack and/or death from coronary heart disease by 60-90%. Another finding was that antioxidant vitamins had no beneficial effect on the outcomes. Conducted by researchers at the University of Washington (Seattle, USA; www.washington.edu), the study was published in the November 29, 2001, issue of The New England Journal of Medicine.

Treatment with a statin drug was found to lower levels of low density lipoprotein (LDL) by 43%, while the use of niacin was found to boost levels of high density lipoprotein (HDL) by 26%. The study found that this combined treatment in people with low levels of HDL and average levels of LDL also decreased plaque buildup. In spite of some prior evidence that antioxidant vitamins could protect against cholesterol buildup, the study showed that people who took vitamins C, E, beta carotene, and selenium received no cardiovascular benefit. Instead, these vitamins were found to blunt the expected rise in HDL cholesterol usually resulting from treatment with statin and niacin. The researchers are uncertain as to the cause.

In another recent trial, the use of certain other vitamins was found to prevent repeat blockage of the coronary artery after angioplasty. Conducted by researchers at the University of California, San Diego (CA, USA), in collaboration with the Swiss Cardiovascular Center (Bern), this study was also published in the November 29, 2001, issue of The New England Journal of Medicine.

The researchers found that patients who took one milligram of folic acid, 400 micrograms of vitamin B-12, and 10 milligrams of vitamin B-6, the risk of restenosis dropped 48%. It has been known that these vitamins lower homocysteine levels and that slightly elevated homocysteine levels are associated with an increased risk of heart disease, but this is the first clinical trial to examine the effects of these vitamins on heart disease.

"This has proven to be a very effective and inexpensive treatment for preventing coronary restenosis,” said Guido Schnyder, M.D., a UCSD cardiologist and visiting scholar from Switzerland who led the vitamin study.



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