Cholesterol Drugs May Protect Prostate, Sex Potency, Study Says

From Bloomberg News

Cholesterol drugs taken to prevent heart attacks may also lower the risk of prostate cancer and impotence in aging men, researchers said.

Men taking any of several different statin drugs for their cardiovascular health had a threefold lower chance of being diagnosed with prostate cancer compared with those not taking the drugs, according to a 15-year study of men ages 40 to 79 by the Mayo Clinic of Rochester, Minnesota. Those taking any of the medicines, including Merck & Co.’s Zocor and Pfizer Inc.’s Lipitor, also had a lower incidence in later years of erectile dysfunction, benign prostate enlargement and urinary problems.

Prostate cancer is the leading malignancy affecting men and the second deadliest, with 186,320 cases and 28,660 deaths in the U.S. in 2008, said the American Cancer Society. The new research may not reflect a true drop in prostate cancer, the authors said, because statins may merely lower the levels of one indicator, prostate specific antigen, rather than cancer itself.

“If you are taking a statin for a heart condition or to lower cholesterol, these studies suggest that statins could have other benefits,” said study author Jennifer St. Sauver, a Mayo Clinic epidemiologist. “It’s clear we need more information before men are advised to start taking statins for their urological health.”

The findings, being presented at the American Urological Association meeting in Chicago, came from a long-term observational study of 2,447 men in Olmstead County, Minnesota. Beginning in 1990, the study tracked the varied effects of statin use on men’s health as they age, researchers said.

Mixed History

An American Cancer Society official urged caution in interpreting the results, noting that statin cancer studies have a history of mixed results.

“We’ve had studies over the course of several years that suggested statins have a protective or preventive effect with respect to certain cancers. Subsequent studies failed to support that observation,” said J. Leonard Lichtenfeld, deputy chief medical officer of the society in an April 24 telephone interview. “Are there other potential explanations for what you’re seeing? There may be an association but not causation.”

A previous study of 1 million people observed by the American Cancer Society’s CPS-II research found no effect of statins on cancer, he said.

Funding Disclosed

The Mayo Clinic research was funded by the U.S. National Institutes of Health and by the research unit of Merck, St. Sauver said.

One-third of the 2,447 men in the study were taking one of several statins. Of those, 38 men, or 6 percent, were diagnosed with prostate cancer. Men not taking statins were three times more likely to develop prostate cancer, researchers said.

Until now there has been limited evidence to support a theory that statins could protect against development of cancer, researchers said. “Our research provides evidence that statin use is associated with a threefold reduced risk of being diagnosed with prostate cancer,” said study leader Rodney Breau, a Mayo urologic oncology fellow, in a statement.

While previous studies have suggested a link between statins and prostate cancer prevention, St. Sauver said the strength of the association found in the study was a surprise. “It’s very strong. I must say we were pretty excited,” she said in an April 24 telephone interview.

Preliminary

The findings are preliminary, said senior author Jeffrey Karnes, a Mayo Clinic urologist. He added that more medical trials are needed to determine whether statins prevent prostate cancer.

“In the United States, one in six men will develop prostate cancer,” Karnes said in a statement. “Far more will develop heart disease. I tell my patients to take care of their heart -- because what’s good for the heart is also good for the prostate.”

The prostate, a chestnut-shaped gland beneath the bladder that makes semen to transport sperm, is enlarged in one in four men ages 40 to 50 and half of men ages 70 to 80.

Statins are known to lower prostate specific antigen, a protein that is tested in the blood to assess the chance of prostate cancer, St. Sauver said. In this study, statin drugs may have simply lowered PSA so the men were “less likely to go for a biopsy and get a diagnosis of prostate cancer,” rather than actually preventing tumors, she added.

Participants in the study group took an array of different statin drugs, St. Sauver said, with 40 percent being given simvastatin, marketed as Zocor by Whitehouse Station, New Jersey-based Merck, and 35 percent taking atorvastatin, marketed as Lipitor by New York-based Pfizer. Others took products such as lovastatin, sold by Merck as Mevacor, and pravastatin, sold by Bristol-Myers Squibb Co. as Pravachol.

Sexual Impact

Researchers also reported men’s ability to have erections benefited from statin use in those ages 60 or older, and in younger men as well on long-term statin use. Those who took statins for nine years were 64 percent less likely to develop erectile dysfunction than those who didn’t take the drugs, while men who took statins for fewer than three years showed no reduction in risk for that problem.

The study also found benign prostate enlargement was 57 percent less likely and urinary problems 63 percent less likely in men taking statins than in the others, researchers said.

“Statins have been shown to have anti-inflammatory effects, and previous research suggests inflammation may be associated with benign prostate disease,” said St. Sauver.

Limitations of Olmstead County study included the fact that all participants were white, making it hard to extend the findings to other ethnic groups, she said in the interview.

Posted by Scott W. Yates, MD, MBA, MS, FACP