Last Updated: 2003-08-25 14:17:12 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Treatment with the cholesterol-lowering "statin" drug Pravachol can improve how well blood reaches the muscle of the heart, and this is not necessarily reflected by changes in cholesterol levels.

"Individuals vary greatly in their coronary risk and response to statin and other treatments," Dr. Ronald G. Schwartz told Reuters Health, and cholesterol levels relate to only a small part of their risk. "We need to focus on treating the big picture of risk, not the small picture of the cholesterol profile."

As described in the Journal of the American College of Cardiology, Dr. Schwartz, from University of Rochester School of Medicine, New York, and others used heart scans to follow 25 patients with heart disease and poor cholesterol readings during the first six months of Pravachol treatment.

By six weeks, LDL ("bad") cholesterol, total cholesterol, and triglycerides dropped by about 30 percent, and this persisted after six months, the researchers report.

Blood flow to the heart muscle did not change until six months, but when it did it improved from severe to moderate-average in the group as a whole. In fact, it became normal in five of the patients.

Improvements in cholesterol did not relate to heart-muscle blood-flow, the team found.

Heart scans "are much more powerful predictors of coronary event risk than the lipid profile, which is the focus of our national guidelines," Dr. Schwartz said.

He believes scans can help make sure patients are getting treatment that works best for them, tell patients and their doctors more accurately how well the treatment is working, and improve heart disease as much as possible.