Heart

Early statin initiation associated with sustained CV benefits

April 9, 2025

Early statin therapy led to long-term benefits in hypertensive patients, reinforcing the importance of early and sustained lipid-lowering interventions to reduce cardiovascular morbidity and mortality. These findings support the early introduction of statins in at-risk populations to achieve lasting cardiovascular protection.

Study details: Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT)-Legacy followed 4,605 hypertensive UK participants with total cholesterol <6.5 mmol/L (251 mg/dL), initially randomized to atorvastatin (n=2,317) or placebo (n=2,288). After the trial's 3.3-year conclusion, all participants were offered atorvastatin, with follow-up extending up to 21 years.

Results: Atorvastatin significantly reduced non-fatal MI and fatal coronary heart disease events (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.69-0.94; p=0.006), total coronary events (HR, 0.88; 95% CI, 0.80-0.98; p=0.017), and cardiovascular deaths (HR, 0.86; 95% CI, 0.74-0.99; p=0.048). No significant reduction in heart failure, strokes, total CV events and all-cause mortality was observed. Long-term outcomes were strongly associated with initial LDL-cholesterol reduction, with HRs per 1 mmol/L (39 mg/dL) decrease showing significant reductions across various cardiovascular outcomes.

Source:

Sever PS, et al; ASCOT Investigators. (2025, March 26). Heart. Long-term benefits of atorvastatin on the incidence of cardiovascular events: the ASCOT-Legacy 20-year follow-up. https://pubmed.ncbi.nlm.nih.gov/40139683/