Consistency is key for patients taking cholesterol-lowering drugs, according to a study linking fluctuations in cholesterol levels to increased risk of heart attack and stroke.
Published in the Journal of the American College of Cardiology, this study tested the association between changes in “bad” cholesterol (LDL, or low-density lipoprotein cholesterol) and cardiovascular risk. While reductions in cholesterol help lower cardiovascular risk, cholesterol levels can fluctuate based on a number of factors. These changes may impact risk for life-threatening heart events.
More than 9,500 patients with heart disease participated in the study, all of whom took cholesterol-lowering statins to help lower risk of heart attack and stroke. The subjects were randomly assigned to take a low or high dose of atorvastatin (10 mg/day vs. 80 mg/day) during the study period. Researchers followed patients for up to five years, periodically testing their cholesterol levels and tracking health outcomes.
After analysis, investigators found that patients taking the higher dose of atorvastatin had less fluctuation in cholesterol levels than those on the lower dose. The more a patient’s cholesterol levels varied from visit to visit, the greater their risk for heart attack, stroke and death. Findings suggest that for patients with heart disease, maintaining consistently low cholesterol is important to reducing cardiovascular risk. Treating patients more aggressively, especially those at high risk for heart attack and stroke, may help stabilize cholesterol levels more effectively.
As experts point out, taking cholesterol medication as prescribed is an important part of achieving consistent cholesterol levels. Statins can cause side effects, like muscle pain and weakness, in some patients, causing some to skip doses or stop taking the medication altogether. Since statins are taken daily, even small changes to the schedule can cause the medication to not work as well as it would if taken properly.
Other factors can also play a role in cholesterol levels, and authors encourage future research on the subject. Nearly one in three U.S. adults has high cholesterol. Very few have their condition under control. With future research, experts hope to identify the best possible treatments to help patients not only reduce bad cholesterol levels but maintain consistent healthy cholesterol levels over time.