Heart Protection Study

The Heart Protection Study was a large randomized controlled trial run by the Clinical Trial Service Unit, and funded by the Medical Research Council (MRC) and the British Heart Foundation (BHF) in the United Kingdom. It studied the use of statin (simvastatin 40 mg) medication and vitamin supplementation (vitamin E, vitamin C and beta carotene) in patients who are at risk of cardiovascular disease.

Results
An outline of the study protocol was published in 1999. Initial results were published in 2002, which indicated that vitamins made little difference in modifying cardiovascular risk, but that simvastatin could significantly reduce the risk of cardiovascular events. Further results, from 2003 and 2004, focused on the role of simvastatin in diabetics and preventing stroke. A 2005 paper analyses the cost-effectiveness of a prescribing strategy similar to the one employed in the study.

Interpretation
The HPS is to date the largest study to investigate the use of statins in the prevention of cardiovascular disease. While there have been concerns about side-effects (myopathy and rhabdomyolysis), these were rare in this study.

The number needed to treat in the study was 57 patients to postpone one death and 19 to prevent one cardiovascular "event" (in those taking the drug simvastatin for 5 years). There was no mortality benefit in women. Cancer risk was suggestively lower in the treatment group (this has been the subject of other studies; for example, the PROSPER study found more cancer deaths and significantly more cancer incidence). No worsening of lung disease was found, an initial concern with statin drugs, and simvastatin did not decrease osteoporosis.

The CTSU branch of Oxford has been criticized for not releasing all group study data about deaths and for inappropriately combining dissimilar endpoints and groups to suggest benefit for all. Having received over £m105 ($m200) from cholesterol-lowering drug manufacturers in addition to the funding from the sources listed above, their objectivity has been questioned.