Daily Statin Reduces Heart Disease Risk Among Adults with HIV

Loose tablets on a white table, with a sealed pack of tablets in the background.

Statin tablets may offset cardiovascular risk in people living with HIV.

Photo: ROGER ASHFORD/SHUTTERSHOCK

An NIH-supported study found that statins, a class of cholesterol-lowering medications, may offset the high risk of cardiovascular disease in people living with HIV by more than a third, potentially preventing one in five major cardiovascular events or premature deaths in this population. People living with HIV can have a 50-100% increased risk for cardiovascular disease. The findings are published in the New England Journal of Medicine.

“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 NHLBI, a study funder. “Additional research can further expand on this effect, while providing a roadmap to rapidly translate research findings into clinical practice.”

For the double-blinded phase 3 trial, known as Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) study, researchers randomized participants into either a treatment group, where they received a daily statin—in this case pitavastatin calcium—or a control group, where they received a placebo pill that contained no medication. The researchers followed participants for about five years, but ended the trial early when they discovered the treatment benefits outweighed potential risks.

To understand the benefits, the researchers compared how often participants in each group experienced major cardiovascular events, including heart attacks, strokes or surgery to open a blocked artery. They found participants who took daily pitavastatin had 35% fewer major cardiovascular events than those who took a placebo.

“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, 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.”