Cholesterol Lowering Drugs Stall Disease Progression In People With Below-Average Blood Cholesterol Level

is a widely used noninvasive technique to measure atherosclerosis in the carotid arteries. The degree of narrowing in the carotids is an indication of the amount of atherosclerosis elsewhere in the body. From the scans, the researchers could measure the thickness of the carotid artery wall; an increase in artery thickness over time indicated an increase in atherosclerotic deposits. At the end of four years, 77 percent of the pravastatin and 78 percent of the placebo patients remained in the study. The New Zealand researchers found that the pravastatin group had average total cholesterol of about 39 mg/dL (19 percent) lower than the placebo group. The average increase in carotid artery thickness was 0.048 millimeters (0.00187 inch) in the placebo group and a decrease in thickness of 0.014 millimeters (0.00055 inch) in the pravastatin group. "There was clearly a major difference between the two groups," MacMahon says. "We showed that cholesterol lowering with pravastatin appeared to prevent the progression of atherosclerosis in the carotid artery."

The effect of treatment was the same for those with above-average levels as those with average or below-average levels, according to MacMahon.

The drug group also had 27 percent lower "bad" low-density lipoprotein cholesterol, which is involved in building up artery deposits, and a 19 percent lower apolipoprotein B, a protein associated with "bad" cholesterol. The drug group also had a 13 percent lower level of triglycerides, the chemical form of fat in most foods; four percent higher apolipoprotein A1, a protein that appears to increase heart attack risk; and four percent higher "good" high-density lipoprotein cholesterol, which carries cholesterol away from blood vessel walls.

Does this study indicate that lowering cholesterol with a low fat diet also will prevent atherosclerosis? "Certainly, we would hope that cholesterol lower

Contact: Carole Bullock
American Heart Association

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