Cholesterol-lowering

People at risk of heart attack, benefit from intensive cholesterol lowering therapies.

The National Cholesterol Education Program (NCEP) has updated its guidelines for treatment of blood cholesterol and has said that people at risk for heart attack and stroke would benefit from more intensive cholesterol-lowering therapies.

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Dr. Scott M. Grundy, director of the Center for Human Nutrition at UT Southwestern Medical Center at Dallas, said that the new guidelines are based largely on results from five major clinical trials involving cholesterol-lowering medications called statins.

NCEP identifies three categories of risk based on a person's likelihood to develop cardiovascular disease (heart attack and stroke) in the near future: high risk, moderately high risk, and lower to moderate risk.

High-risk individuals are those who have already had a heart attack, cardiac chest pain (angina), previous angioplasty or bypass surgery. The new recommendations for this group give physicians the option of reducing LDL cholesterol to less than 70 mg/dL.

Moderately high-risk individuals are those who have two or more risk factors for coronary heart disease and have a 10 percent to 20 percent chance of having a heart attack in the next 10 years. Recent clinical trials strongly suggest that moderately high-risk people will receive additional benefit if their LDL levels are reduced to less than 100 mg/dL.

Recent clinical trials also provide strong evidence that cholesterol-lowering therapy is effective in reducing cardiovascular disease in patients with diabetes as well as older persons who are at risk.

"It has been gratifying to see research in the cholesterol field come to fruition to save so many lives," said Grundy.

"The report also emphasizes the importance of making lifestyle changes that help with cholesterol management, including eating a low-saturated fat, low-cholesterol diet, increasing fiber intake, losing weight, and exercising regularly. These should always be employed when patients are given cholesterol-lowering drugs," added Grundy.