Professor and Expert on Statins Publishes Guidance for Clinicians

Hennekens has published an editorial in the current issue of Trends in Cardiovascular Medicine about guidance for clinicians based on the most recent updated guidelines from the American Heart Association and American College of Cardiology. His guidance will assist clinicians to address the clinical and public health challenges to increase utilization of statins in the treatment and prevention of heart attacks and strokes. He and co-author Marc A. Pfeffer, M.D., Ph.D., Dzau Professor of Medicine at Harvard Medical School, provide guiding principles to aid clinicians to make the best judgment about whether to prescribe statins after consideration of the totality of evidence, which includes the entire risk profile of the patient as well as the benefits and risks of the drug.

In their invited editorial, Hennekens and Pfeffer state that all guidelines provide a necessary, but not sufficient basis for the astute clinical judgment of a clinician for each of his or her patients. They reemphasize that the totality of randomized evidence indicates that there is no threshold for low density lipoprotein cholesterol below which there are no net benefits of statins. These emerging issues in the treatment and prevention of heart attacks and strokes present new clinical challenges to healthcare providers to more widely prescribe statins in the treatment and prevention of heart attacks and strokes.

“The evidence indicates clearly that the more widespread and appropriate utilization of statins, as adjuncts, not alternatives to therapeutic lifestyle changes, will yield net benefits in the treatment and prevention of heart attacks and strokes, including among high, medium and low risk patients unwilling or unable to adopt therapeutic lifestyle changes,” said Hennekens.

According to the Centers for Disease Control and Prevention, heart disease is the leading killer among U.S. men and women, causing approximately 600,000 deaths each year.

Hennekens was the founding principal investigator of the landmark Physician's Health Study of 22,071 doctors. He also was a subject in the trial and took a placebo for five years when the federally funded investigator-initiated research grant was terminated early based on the unanimous recommendation of the external and independent Data and Safety Monitoring Board due, principally, to the emergence of a statistically extreme and clinically important reduction in a first heart attack among those assigned at random to aspirin. He was the first researcher in the world to discover that aspirin prevents a first heart attack. He also was the first to demonstrate that aspirin prevents heart attacks, strokes, and cardiovascular deaths when given within 24 hours after onset of symptoms of a heart attack as well as to a wide variety of patients who have survived an event associated with a blockage in the heart, brain, or legs.

Hennekens’ landmark and first discoveries on aspirin are not limited to cardiovascular disease and include the prevention of recurrent migraine headaches. He also has hypothesized that aspirin may decrease risks of colorectal cancer and delay cognitive loss as well as to reduce the development of type 2 diabetes. Based on his initial observations to formulate the hypothesis, other investigators recently demonstrated that aspirin prevents colon polyps a well as colorectal cancer.

From 1995 to 2005, according to Science Watch, Hennekens was the third most widely cited researcher in the world and five of the top 20 were his former fellows and/or trainees. In 2012, Science Heroes ranked Professor Hennekens No. 81 in the history of the world for having saved more than 1.1 million lives, which placed him two ahead of professor Jonas Salk ranked No. 83 for the development of the polio vaccine. In 2013, he received the “Fries Prize for Improving Health” and in 2014, he received the Alton Ochsner Award for his pioneering work on smoking and health. In 2015, he was ranked the No. 14 “Top Scientist in the World” based on his H-index of 173. - FAU -

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