Statins Help Obese People After Bypass Surgery

By Ed Edelson
HealthDay Reporter
Friday, August 15, 2008; 3:00 PM

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FRIDAY, Aug. 15 (HealthDay News) -- Statins reduce the perils facing obese people after they have the bypass surgery that restores blood flow to an endangered heart, a study finds.

The study was done to help settle a running controversy about the ill effects of obesity in such cases, said Dr. Christina C. Wee, an associate professor of medicine at Harvard Medical School, co-director of research in the division of general medicine at Beth Israel Deaconess Hospital and lead author of a report in the Aug. 19 issue of the Journal of the American College of Cardiology.

"We know that obesity, per se, is a risk factor for developing heart disease," Wee said. "But once you develop it, is obesity more detrimental than not being overweight? There have been different studies with results going both ways."

To settle the issue, Wee and her colleagues studied the outcome of bypass surgery for 1,314 people in a controlled trial, using their body-mass index (BMI) as a measure of obesity. They found that a higher BMI was associated with a higher likelihood that arteries would become blocked again.

One arm of the trial compared progression of the condition in people given either low or high doses of a statin.

"What we found was somewhat surprising," Wee said. "With low-dose statin therapy, obesity was detrimental, with more blockage. What was unexpected was that with high doses of the statin, obesity did not have much of an effect at all."

While statins are prescribed to lower blood levels of LDL cholesterol, the effect seen in the study probably had a different cause, Wee said.

"We know that statins do more than lower cholesterol," she said. "They lower inflammation, and people who are obese have greater inflammation. There is a lot of evidence that inflammation in general is not good. Since a person who is obese has more of that going on, statins tend to protect."

The study offers a good argument for giving statins after bypass surgery, Wee said. "What we can say is that if you have heart disease, particularly if you had bypass surgery, you should be on a good dose of a statin," she said. The dosage described as "high" in the study now is regarded as standard, Wee added.