The Benefits of Cholesterol
Lowering
Recent
studies have shown that cholesterol lowering in people without heart disease
greatly reduces their risk for developing CHD, including heart attacks and
CHD-related death. This is true for those with high cholesterol levels and for
those with average cholesterol levels.
A 1995
study called the West of Scotland Coronary Prevention Study (WOSCOPS) found
that cholesterol lowering reduced the number of heart attacks and deaths from
cardiovascular causes in men with high blood cholesterol levels who had not had
a heart attack. For 5 years, more than 6500 men with total cholesterol levels
of 249 milligrams per deciliter (mg/dL) to 295 mg/dL were given either a
cholesterol-lowering drug or a placebo (a dummy pill that looks exactly like
the medication), along with a cholesterol lowering diet. The drug that was
given is known as a statin (pravastatin), and it reduced total cholesterol
levels by 20 percent and LDL ("bad") cholesterol levels by 26
percent. The study found that in those receiving the statin, the overall risk
of having a nonfatal heart attack or dying from CHD was reduced by 31 percent.
The need for bypass surgery or angioplasty was reduced by 37 percent and deaths
from all cardiovascular causes by 32 percent. A very important finding is that
deaths from causes other than cardiovascular disease were not increased, and
the overall deaths from all causes were reduced by 22 percent.
In 1998,
the results of the Air Force/Texas Coronary Atherosclerosis Prevention Study
(AFCAPS/TexCAPS) showed that cholesterol lowering in generally healthy people
with average cholesterol levels reduced their risk for a first-time major
coronary event by 37 percent. Study participants had no obvious evidence of CHD
and relatively usual total cholesterol levels (average of 221 mg/dL) and
LDL-cholesterol levels (average of 150 mg/dL) and lower than usual HDL
("good") cholesterol levels (average of 36 mg/dL for men and 40 mg/dL
for women). This study used a statin drug (lovastatin) along with a
low-saturated fat, low-cholesterol diet to lower cholesterol levels. Study
participants who received a placebo followed the same low-saturated fat,
low-cholesterol diet. After one year, total cholesterol levels in the treatment
group were lowered by 18 percent and LDL-cholesterol levels by 25 percent. The
risk for a heart attack was reduced 40 percent, unstable angina 32 percent, the
need for bypass surgery or angioplasty 33 percent, and cardiovascular events 25
percent. The cholesterol-lowering benefits in this study extended to both men
and women as well as older adults. There were no significant differences
between treatment and placebo groups in non-cardiovascular disease deaths.
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