high cholesterol

An article published in the British Medical Journal discusses a study on the long-term use of statins for patients with high cholesterol.

A recent study explored the long-term use of statins in patients with high levels of low-density lipoprotein (LDL) cholesterol. LDL cholesterol transports fat to cells, where they can build up and cause atherosclerosis. This causes the inside of arteries to narrow, which can lead to serious cardiovascular events.

The British Medical Journal recently summarized this 15-year follow-up study, reporting that statin treatment decreased deaths from coronary heart disease by 28% in men with high cholesterol who had no other risk factors.

Their findings report new information regarding men with high cholesterol who do not have pre-existing vascular disease and their risk of cardiovascular events. The study reported that men with an LDL-cholesterol value of over 190mg/dL are at a two-fold higher risk of experiencing a cardiovascular event.  The authors, therefore, state that this study is the first of its kind to support, through a randomised trial, the use of statins for these individuals with high LDL-cholesterol levels with no other risk factors.

Of all the men in the study initially given pravastatin, the study found over a 20-year follow-up that there was a decrease in the risk of coronary heart disease (22%), cardiovascular death (17%), and all-cause mortality (12%). The men within the study specifically with LDL cholesterol over 190mg/dL who were also initially given statins demonstrated a decreased risk of coronary heart disease death (28%), cardiovascular death (25%), and all-cause mortality (18%).

Although this study was performed on a post-hoc basis, the authors highlight that it would be unethical to perform a placebo-controlled trial to investigate statin use in people with LDL-cholesterol over 190mg/dL.

In the report to the British Medical Journal, study leader Kausik Ray said, “For the first time, we show that statins reduce the risk of death in this specific group of people who appear largely healthy except for very high LDL levels. This legitimises current guidelines, which recommend treating this population with statins.”

Written by Jade Marie Evans, MPharm, Medical Writer

1) Jacqui Wise. (2017). Long term study backs statins for patients with high LDL and no other risk factors. Available: http://www.bmj.com/content/358/bmj.j4171. Last accessed 6th Nov 2017.
2) Vallejo-Vaz A et al. (2017). LDL-cholesterol lowering for the primary prevention of cardiovascular disease among men with primary elevations of LDL-cholesterol levels of 190 mg/dL or above: analyses from the WOSCOPS 5-year random is. Available: http://circulationjournal.org/. Last accessed 6th Nov 2017.


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