Statins May Worsen Heart Failure for Some



WEDNESDAY, Nov. 4, 2009 ( — It’s widely known that cholesterol-lowering statins can benefit patients with heart disease, but a new study suggests they may actually harm some people with heart failure.

Heart disease can occur when arteries become clogged, but in heart failure, the heart gets progressively weaker and larger.

Still, since the study included a small number of patients and looked at only one point in time, it’s too early to say if the findings have implications for heart failure patients taking statins, according to lead author Lawrence P. Cahalin, PhD, of Northeastern University, in Boston. Cahalin presented his findings on Tuesday at the American College of Chest Physicians annual meeting in San Diego.

Tamara Horwich, MD, an assistant professor of medicine at the University of California, Los Angeles, agrees that the results need to be interpreted with caution. “I just don’t think we can draw any conclusions about statins having benefits versus ill effects in some patients,” says Dr. Horwich, who wasn’t involved with Cahalin’s study.

In heart failure, the enlarged heart struggles to pump a sufficient amount of blood, which can cause fluid to collect in the limbs and lungs, resulting in shortness of breath and fatigue. However, one type of heart failure, systolic, occurs when the lower chambers of the heart can’t contract with enough force to drive blood throughout the body.

In the other type, diastolic heart failure, the heart muscle is so stiff that it can no longer relax enough to fill with blood between beats. About half of people with heart failure have systolic; the other half have diastolic, which becomes more common with age and is more likely to strike women.

About 5 million Americans have heart failure.

Currently, there are no guidelines on whether patients with heart failure should take statins. Some studies have shown that they can be helpful, while others have found no benefit. The decision of whether to prescribe these drugs is typically based on a patient’s cholesterol levels, his age, and whether he also has coronary artery disease, according to Dr. Horwich.

“There’s not a consensus,” she says. “It’s up to the individual physician to make a decision.”

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