So maybe they really should put statin drugs in the water supply, as some heart doctors only half-jokingly suggest.
The put-it-in-the-water quip inevitably surfaces whenever heart specialists gather to talk pills. It echoes both their confidence in statins' power to lower cholesterol and their frustration that millions miss out.
Statins are one of the true medical breakthroughs of recent times. They spectacularly reduce cholesterol, and they do it far better than even the most draconian diet and exercise programs. A 60-point drop in cholesterol is nothing special on statins.
Statins keep arteries from clogging and may even reverse the process. People on statins lower their risk of heart attacks by about one-third. And they live longer.
Furthermore, the drugs are easy to take, and side effects are rare.
About 8 million Americans now take them, but experts say 20 million, perhaps even 30 million, should be on statins.
Statin drugs "have had the greatest impact of anything I've seen over the past three decades," says Dr. Antonio Gotto, a cardiologist and dean of the Cornell University medical school. "With wider application, they have the potential of making a tremendous dent in death and disability from coronary disease."
Why are these life-saving medicines so underused?
Some patients are too pill-phobic to take them. And at $100 a month, price alone keeps many off the drug. However, prices are likely to fall in the next two to three years as the drugs lose patent protection and cheaper generics appear.
Some primary-care physicians are too out of touch to know much about the drugs, and others may not want the extra work involved in persuading patients to take statins, checking their cholesterol counts and adjusting the doses as necessary.
"Physicians tend to be a real show-me group that changes slowly," says Dr. Calvin Weisberger, a Kaiser Permanente cardiologist in Los Angeles.
However, medical shortcomings have a way of healing themselves over time, and underuse of statins is likely to do the same. Experts estimate that statin prescriptions rose by almost one-third last year. And some doctors say the aversion to prescribing statins appears to be easing.
Five brands are available: Lipitor, Zocor, Pravachol, Lescol, Mevacor and Baycol. They are called statins because their generic names, such as lovastatin and atorvastatin, all end the same way. The first of them came on the market a decade ago, but much of the evidence of their worth has been amassed over the last five years.
