Lowering Cholesterol to Levels of a Newborn Baby Reduces MI Risk
Although previous studies have suggested lowering cholesterol levels may be associated with a lower risk of a myocardial infarction (MI), recent evidence has questioned whether very low levels are beneficial.
In the latest study, Kausik Ray, MD, Imperial College London, London, United Kingdom, and colleagues analysed data from over 5,000 people taking part in 10 cholesterol-lowering trials. These studies utilised a new therapy to reduce cholesterol to much lower levels than previously possible.
The researchers wanted to assess whether reducing cholesterol as low as possible is safe, and whether it was more beneficial than the current levels achieved with existing drugs.
Results showed that reducing cholesterol to the lowest level possible -- to levels similar to those we were born with -- reduced the risk of MI, stroke or fatal heart disease by around a third.
“Experts have been uncertain whether very low cholesterol levels are harmful, or beneficial,” said Dr. Ray. “This study suggests not only are they safe, but they also reduced risk of heart disease, heart attack, and stroke.”
The patients in the studies had previously been diagnosed with high cholesterol, and many were slightly overweight. The mean age was 60 years and the researchers tracked the patients for 3 months to 2 years. The average cholesterol reading was around 125 mg/dL and they were all deemed at risk of heart problems or stroke.
Mostly patients were taking a cholesterol-lowering statin therapy, but just over half were also taking alirocumab every 2 weeks to further lower cholesterol levels. This drug may be needed when patients’ cholesterol levels are not sufficiently lowered by statins.
The combined effect of the new drug and the statin in the trials meant that patients reached very low cholesterol -- lower than 50mg/dL. Lowering levels of cholesterol reduced the risk of MI, stroke, angina or death from heart disease, and for every 39mg/dL reduction in low-density lipoprotein (LDL), the risk reduced by 24%.
“This study not only confirms that LDL can trigger heart problems, but also suggests reducing it in adults to very low levels -- to those of a new-born baby -- is both safe and beneficial,” said Dr. Ray.
The researchers plan to gather longer-term data, to see if the beneficial effects continue.
SOURCE: Imperial College London
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