Research suggests heart disease is reversible

Millions of sufferers from heart disease were given new hope yesterday as doctors revealed that the condition might be reversible.

Previous research has suggested heart disease is a chronic, progressive disease that can be slowed but not reversed.

Now scientists have found that very intensive treatment with a powerful cholesterol lowering drug may reduce the fatty deposits in the arteries.

But the drug, Crestor, manufactured by Astra Zeneca and launched in 2003, has been the focus of controversy after evidence emerged that it could cause a muscle wasting disease.

Warning labels were strengthened by the US Food and Drug administration last year.

Heart disease is caused by the build up of fatty deposits, called atheroma. This narrows the arteries increasing the risk of a blockage caused by a blood clot, triggering a heart attack.

Previous treatment has focused on reducing the build up of atheroma by cutting the level of cholesterol.

Results of an international study released yesterday show that two years treatment with Crestor, whose chemical name is rosuvastatin, cut cholesterol levels by over half and reduced the thickness of the atheroma by 6.8 per cent.

The research found almost four out of five patients (78 per cent) showed some form of reduction in the level of atheroma.

Neal Uren, consultant cardiologist at Edinburgh's Royal Infirmary, said reduction of atheroma was the Holy Grail in the fight to combat heart disease.

"It suggests that very aggressive lowering of cholesterol can actually have an effect on the plaque [fatty deposits] in each of the blood vessels," he said.

Dr Sarah Jarvis, a London GP and member of the Royal College of General Practitioners, said the news was "dramatically exciting" and its importance "cannot be underestimated".

She said: "For the first time we have a drug that can not only halt the progression of the disease, but in the vast majority of patients, it actually showed the disease regress." The British Heart Foundation warned that the study was small with just 349 patients and the drug was the most powerful cholesterol lowering medication on the market, used in the highest dose.

Professor Peter Weissberg, medical director of the foundation, said: "This was extremely aggressive treatment that achieved a small reduction in atheroma. It is not magical. The stuff didn't melt away.

"What the study didn't do is show whether this was an important biological difference. It wasn't designed to test whether this drug regimen actually saves lives, so whilst the results sound promising and are likely to translate into a better outcome for heart patients, we still need further studies to confirm whether the regression demonstrated translates to fewer heart attacks."

The research was conducted in the US, Canada, Europe and Australia.

The results were presented yesterday at the American College of Cardiology annual conference in Atlanta.

The full paper will be published in the Journal of the American Medical Association (JAMA) next month.

The authors write: "Traditional thinking has viewed atherosclerosis as an inexorably progressive disease for which even the most active therapies can merely slow advancement.

The current study suggests that there is potential for a more optimistic strategy, in which aggressive lipid-modulating strategies can actually reverse the atherosclerotic disease process."

- INDEPENDENT