Lower Cholesterol is Better

Researchers from the Walter Reed Army Medical Center in Washington, D.C., found patients who were given a higher dose of a synthetic cholesterol-lowering drug not only had significantly lower levels of "bad" cholesterol after treatment than those given a regular dose of a similar medication, but they also showed a decrease in thickness in the main neck arteries supplying blood to the brain. This main artery plays a key role in the risk of stroke and heart attack.

The study is the first to show lowering cholesterol may actually reserve the signs of heart disease.

Researchers studied about 140 people, half of whom had heart disease. Nearly three quarters were men. About half the group received 40 milligrams of the natural cholesterol lowering statin pravastatin and the other half received 80 milligrams of the new synthetic statin atorvastatin. In addition to testing for cholesterol levels, all patients underwent ultrasound to gauge the thickness of their carotid arteries at six months and one year following the initiation of treatment.

People taking pravastatin lowered their LDL, or "bad" cholesterol levels, on average, to about 110 mg/dL. Those on atorvastatin had levels that dropped to 76 mg/dL. The pravastatin group showed a slight thickening of their carotid arteries after one year, while those on atorvastatin showed a decrease in thickening. Doctors typically recommend lowering LDL to below 100 for people with heart disease and 130 for those without known heart disease.

The investigators believe these findings point to the need for further research into optimal levels of LDL cholesterol to lower the risk of heart disease and stroke. Allen J. Taylor, M.D., from the Walter Reed Army Medical Center, says: "We need to carefully define at what point lower LDL values have the greatest benefit in lowering the risk of heart disease. This study would suggest that LDL values much lower than 100 mg/dL appear better than a value of around 100."

Fellow scientist Prediman K. Shah, M.D., from Cedars Sinai Medical Center in Los Angeles, agrees in an accompanying editorial. He says, "The data provided by Taylor are of potential interest and could have significant implications for clinical practice."

SOURCE: To be published in an upcoming issue of Circulation

[Cardiovascular Health Home]

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