(Circulation. 2001;104:e9051.)
© 2001 American Heart Association, Inc.
American Heart Association 2001 Scientific Sessions
Late-Breaking Science
Statins: The New Aspirin?
No work presented at American Heart Association’s 2001 Scientific Sessions is likely to have greater clinical impact than the Medical Research Council/British Heart Foundation Heart Protection Study, reported by Dr Rory Collins (Clinical Trial Service Unit of Oxford University, Oxford, UK). The latest guidelines from the National Cholesterol Education Program probably will have to be modified. Patients (n=20 536) were recruited in 69 UK hospitals, the entry criterion being high risk of coronary heart disease without a clear indication for cholesterol-lowering therapy. Specifically targeted were women, people >70 years of age, people with diabetes, those with noncoronary vascular disease, and those with average or below-average cholesterol levels. Patients were 40 to 80 years old (28% age 
70 years) and one fourth were women. Two regimens were under investigation: simvastatin (40 mg daily), and a cocktail of antioxidant vitamins (vitamin E [600 mg], vitamin C [250 mg], ß-carotene [20 mg daily]). Patients were randomized to 4 groups of 
5000 each, receiving simvastatin alone, simvastatin plus vitamins, vitamins alone, or placebo. Average follow-up period was 5.5 years. In the vitamin part of the study, the results were entirely negative. No benefit or harm was evident in terms of vascular disease or any other disorders (including cancers). By contrast, striking benefits were seen with simvastatin. The primary end points for the comparison of simvastatin and placebo were all-cause mortality (12.9% versus 14.6%, respectively) and deaths from heart disease and related blood vessel disease (7.7% versus 9.2%, respectively). Secondary end points were stroke (4.4%