Battle for our hearts and minds

Should everyone be taking a statin? The cholesterol-lowering drugs are already among the most widely prescribed medications in the U.S. But they could soon be part of a daily regimen for many more people. This would be thanks to growing evidence that cholesterol levels once considered healthy may

Eight million Americans are already taking statin drugs but if cholesterol guidelines issued two years ago by the federal government were applied, another 36 million could take them as well.

Pfizer's Lipitor, the top-selling statin drug, got a boost last week from a study of 502 middle-aged heart patients directed by Dr. Steven Nissen of the Cleveland Clinic. The study found that Lipitor was more effective than Bristol-Myers Squibb's Pravachol in reducing levels of low density lipoprotein, better-known as LDL, the so-called bad cholesterol. Unlike Pravachol, Lipitor also appeared to halt the progression of coronary artery disease. Pfizer is expected to sell more than $5 billion worth of Lipitor this year and its stock traded up on the news.

Meanwhile, Merck and Johnson & Johnson are reportedly preparing to seek FDA approval to sell an older statin drug, Mevacor, now off-patent, in an over-the-counter formulation. The FDA rebuffed a previous such application but has hinted it might change its mind if it is convinced the drug can lower cholesterol in a low-dosage form.

Not to be outdone, East Hanover-based Novartis, meanwhile, plans to use results from a study of its own top-selling drug, Diovan, to broaden its marketing. The study found that Diovan, approved to treat high blood pressure and heart failure, is as effective as an older class of blood-pressure drugs called ACE inhibitors, which are now available as generics. The study could prompt doctors to switch patients who have problems with ACE inhibitors to Diovan.