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Comparing Cholesterol Lowering Medications for High Risk Patients

CardioSmart News

When it comes to high cholesterol treatment, it doesn’t matter which type of cholesterol-lowering drugs patients choose as long as they work, based on a recent study that links greater reductions in bad cholesterol to reduced risk for heart events and death.

Published in the European Heart Journal, this study compared how well different types of cholesterol-lowering treatments work at reducing cardiovascular risk. Medication is one of the best ways patients with high cholesterol can help prevent life-threatening heart events. But as patients now have more treatment options than ever before, experts wonder whether certain medications are more effective at reducing risk of complications from high cholesterol.

The recent analysis included data from 19 clinical trials, which tested various types of cholesterol-lowering medication in high-risk patients. Fifteen of the studies tested statins, which have been used for decades to help patients reduce bad cholesterol and prevent heart events. An additional three tested a new class of drugs called PCSK9 inhibitors, which were recently approved for use in high-risk patients, and one tested ezetimibe, which was approved in 2002 for lowering cholesterol.

Together, these studies included more than 152,500 patients with high cholesterol. Most participants already had been diagnosed with heart disease and were taking medication to help prevent a second heart event.

Roughly half of participants were assigned to intensive treatment (high doses of medication), while the other half were assigned to either lower doses or placebo medication with no active ingredients. Researchers followed participants for an average of four years, tracking participants’ cholesterol and key outcomes like heart attack, stroke and death.

After analysis, researchers found that more intensive treatments reduced participants’ risk for heart events and death by 19%. This benefit was similar among all medications, including statins, PCSK9 inhibitors and ezetimibe. Researchers found that the greater cholesterol reduction, the lower participants’ risk for heart events and death.

What this study shows, according to authors, is the importance of reducing cholesterol in high-risk patients. It’s well established that low-density lipoprotein (LDL or “bad” cholesterol”) greatly increases risk for life-threatening heart events. As findings suggest, intensive treatment can help reduce that risk by lowering cholesterol levels—regardless of the type of treatment. Thus, the more effective treatment is at lowering cholesterol levels, the better the outcomes for patients with high cholesterol.

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