Lower LDL cholesterol levels are always beneficial for the heart

Lower LDL levels are always beneficial for heart patients – in fact, even if they are below the currently recommended level of 70 mg per decilitre of blood. This is the outcome of a US study that was presented at the American Heart Association’s “Scientific Sessions 2014” in Chicago (Illinois).

More than 18,000 patients who had experienced an acute cardiovascular event (unstable angina pectoris, heart attack) were included in the nine-year “Improve-It” study. The aim of the study was to reduce LDL levels below 70 milligrammes per decilitre of blood in two comparable groups of high-risk patients. To achieve this, 9,077 patients received 40 mg of the cholesterol-reducing drug simvastatin, and 9,067 study subjects received a combination of 40 mg simvastatin plus ten milligrams of ezetimib. Increasing the dose of simvastatin was possible in case the targeted levels were not reached.

After one year, those patients who had been exclusively treated with simvastatin demonstrated average LDL concentrations of 69.9 mg per decilitre of blood. In those who had received the combination medication, the level even reached 53.2 mg.

Lower LDL levels are also reflected in statistics: in the combination-group, serious complications or a cardiovascular event that resulted in death occurred in 32.7 per cent. In the simvastatin-only group with higher LDL levels, this was the case in 34.7 per cent. Heart attacks occurred in 13.1 per cent (combination group), respectively 14.8 per cent (simvastatin group). Both differences were statistically significant.

For the first time, it was established that a combination therapy for LDL reduction could lead to these results, said study leader Christopher Cannon from Brigham and Women’s Hospital in Boston (Massachusetts). Furthermore, the study supports the hypothesis that cardiovascular risk is linked to LDL cholesterol – the lower the levels, the lower the risk.