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Very Low LDL Cholesterol Produces Greatest Decrease in Risk

Posted: Wednesday, November 07, 2007

Lowering LDL levels to below 64mg/dL, showed the greatest benefits.

According to US and German researchers, reducing LDL cholesterol to levels considerably below current recommended targets appears to provide greater protection in patients with established atherosclerotic disease,

Dr. John C. LaRosa of The State University of New York Health Science Center, New York and colleagues, wrote in the September 1st issue of the American Journal of Cardiology that a post-hoc analysis of data from a clinical trial of atorvastatin, was conducted.

More than 10,000 subjects with coronary heart disease and LDL cholesterol levels below 130 mg/dL had been randomized to receive atorvastatin at 10 mg or 80 mg per day. The primary end-point was time to the first major cardiovascular event.

The researchers found that there was a highly significant reduction in the risk of major cardiovascular events with descending levels of LDL cholesterol. The lowest risk was seen in patients who had achieved levels below 64 mg/dL.

Further analysis showed that that risk of individual events including fatal and non-fatal myocardial infarction and stroke were significantly reduced with lower LDL levels.

In addition, although there was no significant influence across LDL levels on the risk of death from any cause or non-cardiovascular causes, such deaths were lowest in patients with the lowest on-treatment LDL levels.

Overall the researchers conclude that in "patients with established atherosclerotic cardiovascular disease, a further risk reduction without sacrifice of safety can be achieved by reducing LDL cholesterol to very low levels."

Source: Diabetes In Control: Am J Cardiol 2007;100:747-752