title: Ethnic variations in lipid-lowering in response to a statin (EVIREST): a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT).
abstract: BACKGROUND
  Statins improve lipid profiles and reduce cardiovascular morbidity and mortality but there are few data on their relative effects in different ethnic groups.
  
  
  METHODS
  We used data from the randomised, placebo-controlled Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA) to conduct a prespecified comparison of the lipid-lowering efficacy of statin therapy among hypertensive participants from different ethnic groups in the UK and Ireland. The effects of atorvastatin (10 mg daily) and placebo on fasting plasma lipid profiles were compared in matched groups of Whites and Blacks (of African-Caribbean or African origin) and Whites and South Asians (from the Indian subcontinent), adjusting for placebo effect.
  
  
  RESULTS
  In the active treatment group, 156 Blacks and 72 South Asians were compared with 419 and 198 Whites, respectively. In multivariable analyses adjusted for baseline lipid levels and other potential confounders, atorvastatin reduced total cholesterol, low-density lipoprotein (LDL)-cholesterol and triglycerides from baseline in all ethnic groups. There were no clinically or statistically significant differences in the effect between Whites and Blacks or between Whites and South Asians after adjusting for placebo effect; similar proportions in each group achieved lipid targets. There was no significant effect of atorvastatin on high-density lipoprotein (HDL)-cholesterol in any group.
  
  
  CONCLUSIONS
  A standard dose of atorvastatin improved lipid profiles to a similar extent in Whites, Blacks and South Asians. Given the proven benefits of statins, these results suggest that, when used in standard doses, they are likely to be similarly effective for cardiovascular disease prevention in all ethnic groups.
authors: International Centre for Circulatory Health, Imperial College, London, UK. neil.chapman@imperial.nhs.uk
authors: Neil
authors: N
authors: Chapman
authors: Choon Lan
authors: CL
authors: Chang
authors: Mark
authors: M
authors: Caulfield
authors: Björn
authors: B
authors: Dahlöf
authors: Gene
authors: G
authors: Feder
authors: Peter S
authors: PS
authors: Sever
authors: Neil R
authors: NR
authors: Poulter
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000208:ethnology* / Q000517:prevention & control*; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000208:ethnology; D007494:Ireland; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000627:therapeutic use*; D044469:Racial Groups; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin