Thumbs Up For Statins ; No Effect With Vitamins: This massive (20,000+ patients ages 40-80) study was reported at the American Heart Association meeting in Anaheim, Ca. Lead investigator Dr. Rory Collins of the University of Oxford said that patients with a history of stroke, diabetes or any vascular disease, regardless of cholesterol level could benefit.

The study used 40 mg Zocor daily to show a 1/3 reduction in major vascular events (stroke, heart attack, etc) in a study period of 5.5 years. The benefit was seen in all groups - men, women and older patients (6000 were over 79 at the start). Side effects were rare: less than 1% had elevated liver tests, and less than 1 in 1000 had elevated muscle enzymes. Both rates were the same as in those on placebo.

"Statins are the new aspirin," Dr. Collins said.

In a separate substudy of the HPS, an antioxidant vitamin mix of 600 mg E, 350 mg C and 20 mg of beta-carotene produced no benefit. The negative results along with previous reports total some 150,000 patients. In sum, antioxidant vitamins do not prevent heart disease.

Aspirin: The 1st ‘Miracle’ Drug

can cut the risk of death from all causes by a third. So say Dr. Patricia Gum and colleagues at the Cleveland Clinic. Writing in the Journal of the American Medical Association, they studied 1351 people who took a daily aspirin and 1351 who did not. All were patients getting heart stress tests, and were followed for an average of 3.1 years. Those who benefited the most: older patients with heart disease or who couldn’t exercise much..

A group in Milan, Italy reports similar results: a 23% reduction in cardiovascular events in 4495 patients on 100 mg of aspirin daily. A vitamin E study arm (300 mg/day) again showed no benefit.

Simvistatin (Zocor) plus niacin reduce both heart symptoms and artery narrowing. That’s the outcome of a 160 patient study at the University of Washington in Seattle. Writing in The New England Journal of Medicine, Dr Greg Brown and colleagues also found that an antioxidant mix of vitamins E, C, beta-carotene and selenium actually reduced the benefit of the Zocor + niacin. The drugs reduced cardiovascular symptoms from 24% (placebo) over 3 years to 3%; with antioxidants alone 21% had symptoms, with antioxidants and drug: 14%.

Office Closed Feb 9-24: for the annual American College of Cardiology update. We’ll be back Feb 25. Please leave a message if you need an appointment when we return. Sorry, but no medical staff will be in. Please call the day’s covering doctor (through the service 914 993-7010) for any urgent problems. Don’t get stuck without your medications! Call the prescription line (914 962-3182) early for renewals!

More Winners: We have 2 winners in our ongoing contest from those who got their colon cancer screening cards in on time. For December, Walter Moran wins the 2 Hollywood Video rentals. From all the year 2001 submissions, George Martin is the winner. And our thanks to all the year’s participants, who are all winners for trying to "wipe out" colon cancer!

Macular Degeneration: Antioxidants & Zinc Help is the word from the Archives of Ophthalmology. The Age-Related Eye Disease Study Research Group reports that a combination of 400 units of vitamin E, 500 mg vitamin C, beta-carotene 15 mg and 80 mg zinc in nearly 5000 patients produced a 27% reduction in visual loss.

And So Do Statins: A report in the British Medical Journal of 660 patients 66-75 in Sheffield, England found that those on statins had an 89% reduced risk of age related macular degeneration.