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People with HIV who took a daily statin pill lowered their risk of stroke, heart attack or surgery to open clogged arteries by 35%, a clinical trial funded by the U.S. National Institutes of Health found.
Statins have the potential to prevent one in five major cardiovascular events or premature deaths in people with HIV, who otherwise can have a 50% to 100% increased risk for cardiovascular disease, the researchers noted.
“This research suggests that statins may provide an accessible, cost-effective measure to improve the cardiovascular health and quality of life for people living with HIV,” said Dr. Gary Gibbons, director of the National Heart, Lung, and Blood Institute.
“Additional research can further expand on this effect, while providing a roadmap to rapidly translate research findings into clinical practice," Gibbons added in a NIH news release.
For the study, researchers assigned participants to either a treatment group, where they received a daily statin, or a control group, where they received a placebo pill. The statin group got 4 milligrams (mg) of pitavastatin calcium (Livalo) daily.
Researchers followed participants for about five years. They ended the trial early when they discovered the treatment benefits outweighed potential risks.
The study compared how often participants in each group experienced major cardiovascular events. The research team also measured the number of deaths that occurred in combination with major heart incidents during the study period.
They found participants in the treatment group were 21% less likely than those in the placebo group to experience these deaths.
Those who took pitavastatin also had a 30% reduction in their low-density lipoprotein (LDL) cholesterol levels.
“Lowering LDL cholesterol levels reduces risks for cardiovascular events, like having a heart attack and stroke, but these findings suggest there may be additional effects of statin therapy that explain these reduced risks among people living with HIV,” said study chair Dr. Steven Grinspoon, a professor of medicine at Harvard University and chief of the metabolism unit at Massachusetts General Hospital.
“Ongoing research about how statin therapy may affect inflammation and increased immune activation among people with HIV may help us better understand the additional benefits we're seeing with this treatment approach,” Grinspoon added.
The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) began in 2015. It enrolled more than 7,700 adults with HIV, ages 40 to 75, from 145 sites in 12 countries. All were taking antiretroviral therapy.
Participants were an average age of 50 and had low-to-moderate risks for cardiovascular disease. Typically, they would not have been prescribed statins.
More work needs to be done to determine how these results will affect guidelines for the care of people with HIV, the researchers said.
The findings were published July 23 in the New England Journal of Medicine.
The U.S. Centers for Disease Control and Prevention has more on HIV.
SOURCE: U.S. National Institutes of Health, news release, July 23, 2023
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