CLEVELAND, Ohio, Oct 19 (Reuters) - Statins are the world's best-selling drugs, taken by millions to reduce the risk of heart attack by lowering cholesterol levels, but many people who could benefit are not using them and many who do take them get no such benefit, a leading cardiologist said on Tuesday.
Clinical trials have consistently shown that statins reduce the incidence of heart attack by about a third, but a majority of people taking the drugs don't receive this benefit from them, Dr. Eric Topol, head of cardiovascular medicine at the Cleveland Clinic, told Reuters in an interview.
"We just don't know who they are," he said.
Many people who are taking statins should not be on the drugs, while many who are not taking them should be, he said.
"They are misappropriated," Topol said of statins, which must be prescribed. "It's chaos," he added.
Topol said doctors too often focus on reducing patients' low-density lipoprotein, or LDL, the so-called bad cholesterol blamed for clogging arteries and causing heart attacks and strokes.
"Everything tells us it's not the LDL, it's the inflammation process. This LDL-centric thinking is wrong," Topol said.
Blood levels of bad cholesterol are just one factor among many that lead to cardiovascular disease, he said.
The majority of people who have lowered their LDL cholesterol with statins have not reduced their risk of heart attack or stroke, nor do they have better survival rates, Topol said.
The anti-inflammatory properties of statins may be the reason why the drugs seem to be beneficial for other diseases unrelated to cardiovascular disease, he said.
Recent studies suggest statins help bone healing and reduce mild cognitive impairment, the precursor to Alzheimer's disease.
Topol predicted that one day medicines will be matched to individuals' genetic makeup. One such test being developed by the Cleveland Clinic focuses on the five or more genes associated with cardiovascular disease, he said.
Statins are taken by an estimated 13 million Americans, and are sold by AstraZeneca (AZN.L: Quote, Profile, Research) , Pfizer Inc. (PFE.N: Quote, Profile, Research) , Merck (MRK.N: Quote, Profile, Research) , Bristol-Myers Squibb (BMY.N: Quote, Profile, Research) , and Novartis AG (NOVN.VX: Quote, Profile, Research) .
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