Heart Protection Study

About the Trial

HPS randomized 20,536 UK adults with vascular disease or diabetes to simvastatin 40 mg or placebo regardless of baseline cholesterol. Statin therapy reduced major vascular events by about 24 percent, including in those with normal or low LDL. It also tested antioxidant vitamins, which showed no benefit. The trial dismantled the idea of a cholesterol threshold for treatment, showing benefit depends on total vascular risk. The investigators estimated that 5 years of treatment would spare about 70 to 100 per 1,000 such patients a major vascular event. HPS pushed guidelines toward risk based statin prescribing and killed the antioxidant supplement hypothesis for vascular protection.