Cholesterol drugs have the potential to save even more lives in the future and prevent major surgeries

Just as an old bicycle tube can weaken and bulge, the abdominal aorta can also bulge with age.  Although such a bulge – also called an aneurysm – rarely causes symptoms, it can grow large enough to rupture, which usually results in death.

The aorta is the largest artery in the body and supplies the entire body with blood. It starts at the heart and runs down through the chest and abdomen, where it branches out and carries blood to the whole body.

In a new study, researchers from the University of Southern Denmark and Odense University Hospital have examined whether a drug currently used to prevent cardiovascular disease could slow down the development of the aneurysm.

- In our new study, we have found that cholesterol-lowering drugs – so-called statins – provide a clear and safe reduction in how quickly the aneurysms grow, says Jes Lindholt, Professor of Vascular Surgery at the Department of Clinical Research, SDU and OUH, who is one of the researchers behind the study.

- This treatment can help prevent the need for surgeries that would otherwise be required to avert a life-threatening rupture.

The researchers used data from two large Danish screening studies to determine whether cholesterol-lowering treatment can be used preventively. Almost 1,000 Danish men aged 65–74 years have been monitored with annual scans.

A cheap, harmless drug to slow down the development of the aneurysms

Statins are already known to prevent blood clots and are a cornerstone in the prevention of cardiovascular disease.

- On average, we could see that the aneurysms grew half as quickly in people who received the recommended maximum dose of statins, says Joachim Skovbo, a PhD student at the Department of Clinical Research:

-At the same time, our study found that doubling the dose of statins was linked to nearly a 20% lower risk of needing surgery, experiencing a rupture or dying – when each outcome was looked at separately. We expect the effect of the treatment to be even higher than 20% because the patients studied only took half a daily dose on average, and three daily doses are recommended.

The researchers observed this effect even after adjusting for age, smoking, blood pressure and other health conditions – and across multiple sensitivity analyses.

Screening programmes can save lives

- You only need to be screened once with an ultrasound scan, which only takes five minutes, so the major cost of the screening programmes is the surgery, says Jes Lindholt.

- Because the aneurysms rarely cause symptoms, affected people do not realise that they are at risk of a rupture – and that they face nearly three times the risk of developing other cardiovascular diseases. Therefore, they do not receive relevant preventive treatment, Joachim Skovbo explains.

Several countries – including the UK, Germany and Sweden – have introduced national screening programmes for this disease. While the Danish Health Authority recommends that screening programmes for 65-year-old men be introduced in Denmark, this has not yet led to political action.

- The fact that we can now prevent a significant number of surgeries, while also saving many additional years of life because the medicine generally also reduces the risk of death, greatly improves cost-effectiveness, Jes Lindholt explains:

- With that in mind, it’s hard to see any strong arguments against introducing screening in Denmark.