Heart structure and function improved with statins, according to new research

Research, recently presented at the EuroCMR 2017 congress, has suggested that statins are associated with improved heart structure and function, with benefits that were above and beyond the cholesterol lowering effects of the drugs.

“Statins have other beneficial, non-cholesterol lowering effects,” explained lead author Dr Nay Aung, cardiologist and Wellcome Trust research fellow William Harvey Research Institute, Queen Mary University of London, UK. “They can improve the function of the blood vessels, reduce inflammation and stabilise fatty plaques in the blood vessels. Studies in mice and small studies in humans have shown that statins also reduce the thickness of heart muscle but this needed to be confirmed in a larger study.”

Therefore, Aung and team performed a large community-based cohort study, including 4,622 participants, who did not have cardiovascular disease, from the UK Biobank, to investigate the link between statins and heart structure and function. Magnetic resonance imaging was used to measure the ventricular volume and the mass of the left ventricle. To assess the relationship between statin use and heart structure and function, the team use multiple regression, which adjusts for potential confounders.

Out of the study cohort, 17% were taking statins. These patients tended to be older with higher body mass index and blood pressure, and were more likely to have diabetes and hypertension. In this group of patients there was a 2.4% lower left ventricular mass and lower left and right ventricular volumes.

“People using statins were less likely to have a thickened heart muscle (left ventricular hypertrophy) and less likely to have a large heart chamber,” emphasized Aung. “Having a thick, large heart is a strong predictor of future heart attack, heart failure or stroke and taking statins appears to reverse the negative changes in the heart which, in turn, could lower the risk of adverse outcomes.

“It is important to note that in our study, the people taking statins were at higher risk of having heart problems than those not using statins yet they still had positive heart remodelling compared to the healthier control group,” he said.

Aung specified that several studies have already shown the ability of statins to reduce oxidative stress and dampen the production of growth factors, which stimulate cell growth. Additionally, these compounds increase the production of nitric oxide by the cells lining the blood vessels, leading to vasodilation, improved blood flow, lower blood pressure and lower stress on the heart.

“A dual approach should be considered to identify who will benefit most from statins,” Aung summarised. “That means looking at not only clinical risk factors such as smoking and high blood pressure, but also genetic (hereditary) factors which can predict individuals’ response to statins. This is an area of growing interest and one that we are also investigating in our lab with our collaborators.”