MILLIONS of people with heart disease may be able to reverse their illness and stave off heart attacks by taking higher doses of cholesterol-busting drugs, according to a landmark study.

For the first time scientists have found a way of reversing the chronic build-up of fat in arteries, a development dubbed the holy grail in the fight against coronary heart disease. Patients put on intensive treatment with a cholesterollowering statin showed a significant reversal of atherosclerosis, when fatty deposits known as atheroma build up on artery walls. The process, often compared to scale forming in water pipes, causes narrowing of the blood vessels and can lead to fatal conditions including heart attacks and strokes.

Until now, efforts have concentrated on slowing the progress of what was thought to be an irreversible disease. But a major study involving rosuvastatin, known by the brand name Crestor, has shown that patients given much more intense doses can reverse their coronary decline.

British scientists working on the international study, presented yesterday at the annual meeting of the American College of Cardiology in Atlanta, Georgia, said that a more aggressive use of statins appeared to halve the relative risk of heart attacks. Neal Uren, consultant cardiologist at the Edinburgh Royal Infirmary, the only British centre involved in the trial, said that for those who had had a clinical episode, this could offer big improvements in life expectancy.

“The idea used to be that once you had atherosclerosis, you were done for,” he said. “Now we have evidence that this can actually be reversed.”

At least two million people in Britain are thought to suffer from furred arteries. Although some people are genetically predisposed to the condition, it is largely preventable if people follow a healthy lifestyle.

The success of the therapy was found after 349 heart patients were studied over two years at 53 centres in the US, Canada, Europe and Australia. They were given intensive treatment with rosuvastatin, one of the more potent statins, involving at least one 40mg pill each day. Most statins, which are taken daily, come in pills of 10mg or 20mg dosage.

Tests found that as LDL, or “bad” cholesterol, was reduced — to a level of less than 2 millimoles per litre (mmol/l) — fatty deposits in the arteries also showed a slight regression. Almost four out of five patients demonstrated some form of reduction in the level of atherosclerosis. The improvements were greatest in arteries with the greatest disease severity.

The research showed that intensive treatment reduced plaque volume by almost 10 per cent. The drug also reduced levels of LDL by more than 50 per cent and raised levels of HDL, or “good”, cholesterol, by 15 per cent.

The changes in cholesterol levels were the largest ever seen in a major trial of statins. The full paper will be published in The Journal of the American Medical Association on April 5.

A succession of studies has shown the remarkable benefits of taking statins. Possible side-effects, such as muscle weakening and a slight impact on liver function, have only been identified in a tiny minority of cases. In January the National Institute for Health and Clinical Excellence, which advises on best treatments, recommended that anyone at risk of cardiovascular disease should be prescribed the drug. Almost six million people in England and Wales — nearly 15 per cent of all adults — are now eligible for the treatment.

Peter Weissberg, medical director of the British Heart Foundation, said the study was “very encouraging” but added that it remained to be seen that atheroma reduction would mean fewer heart attacks.

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