Statins appear to slow the decline in lung function in elderly patients, even those who smoke, according to research published today in the American Journal of Respiratory and Critical Care Medicine. If confirmed, statins might become a new treatment for chronic obstructive pulmonary disease (COPD).

The study is the first examining relationships between statins and the age-related decline in lung function. Researchers analysed 803 elderly men enrolled in the ongoing Veterans Administration Normative Aging Study, which began in 1963. This group had forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) measured two to four times between January 1995 and June 2005.

Statins seemed to slow the annual decline in lung function. For example, among statin users FEV1 declined by, on average, 10.9 ml a year, compared with 23.9 ml annually in non-users. FVC declined by 14.0 and 36.2 ml annually in statin users and non-users respectively.

Researchers divided the men into four groups: never-smokers, long-ago quitters (_ 10 years), recent quitters (>10 years) and current smokers. Again statin users showed a marked reduction in the speed at which their lung function declined. For example, when the authors compared the difference in FEV1 in recent quitters, the net difference between those using and those not using statins reached 19.7 ml per year. Similarly, in long-time quitters the net difference for FVC reached 24.7 ml annually. “Our results suggest (weakly) that longtime quitters and recent quitters may be able to benefit more from statin use than other groups”.

Statins ability to reduce inflammation in the lung

The researchers suggest that statins’ benefits may arise from their ability to reduce pulmonary inflammation, counter smoking-induced lung damage, lower serum levels of C-reactive protein (a marker of systemic inflammation) and protect against oxidative damage. The authors comment that randomized clinical trials need to confirm the findings. Nevertheless, they conclude that “Our results point to a treatment that could potentially benefit those with COPD in addition to the benefits of stopped smoking … statin use reduces the severity of lung function decline in the elderly, and these beneficial effects seem to be present regardless of smoking history.”

Lung function predicts cardiovascular deaths and total mortality. The decline in lung function also predicts mortality and hospitalizations in chronic obstructive pulmonary disease (COPD). Currently, COPD is the fourth most common cause of mortality world-wide. Epidemiologists predict that COPD will become the third commonest cause of death by 2020. According to IMS, the 2003 annual global market for COPD drugs was worth about $3 billion and could rise to over $9 billion by 2010. The study adds to a growing body of evidence that statin’s benefits may extend beyond lipid lowering. Previous studies suggested, for example, that statins may reduce the risk of developing Alzheimer’s disease.