Study Questions Value of Lower Cholesterol Targets

It may be that statins are better treatment for heart risk factors, researchers say

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THURSDAY, Oct. 12, 2006 (HealthDay News) -- There's no clear evidence that very low levels of low-density lipoprotein (LDL) cholesterol benefit people at high risk for heart disease. Instead, the emphasis should be on getting more of these patients to take statin drugs, says a U.S. study.

In recent years, some experts have recommended very low levels of LDL ("bad") cholesterol (70 milligrams/deciliter) for some high-risk patients, even if it means having to take multiple medications to achieve that goal, noted researchers at the University of Michigan Health System and VA Ann Arbor Healthcare System.

To determine the validity of this approach, the study authors reviewed research on LDL cholesterol and heart health. They said they found no scientific evidence to support the ultra-low LDL target.

The researchers concluded that it would be better to concentrate less on cholesterol and to get more people with multiple heart disease risk factors to take statin drugs -- regardless of the patients' cholesterol levels.

Statins do lower LDL cholesterol, but it's not clear if this lowering of cholesterol is the reason that statins help prevent heart attacks, the researchers said.

"Our review suggests that we in the medical community have misunderstood the scientific evidence on whether very low LDL is important, or whether adequate doses of statins are what is really important," study lead author Dr. Rodney Hayward, director of the VA Center for Health Services Research and Development, said in a prepared statement.

"Current practice guidelines and recommendations often focus on getting LDL as low as possible, but the literature to date doesn't demonstrate that low LDL is what is truly important -- but it does show that statins save lives in high cardiac risk patients regardless of a person's LDL level," said Hayward, who is also professor of internal medicine at the University of Michigan Medical School.

The study was published in the October issue of the journal Annals of Internal Medicine.

More information

The American Heart Association has more about cholesterol.

SOURCE: University of Michigan Health System, news release, Oct. 2, 2006

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