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Medication for hypercholesterolemia and the risk of nonfatal acute myocardial infarction: case-control study in Japan

    Circulation Journal : Official Journal of the Japanese Circulation Society
    |May 28, 2002
    PubMed

    Insights

    Lipid-lowering drugs may not reduce acute myocardial infarction risk in Japan. Untreated high cholesterol increases risk, but treatment effectiveness requires further study, especially regarding achieved cholesterol levels.

    Area of Science:

    • Cardiovascular Epidemiology
    • Pharmacological Intervention
    • Public Health

    Background:

    • Lowering blood cholesterol reduces coronary heart disease (CHD) risk in Western populations.
    • The impact of lipid-lowering drugs on CHD risk in Japan remains largely unknown.

    Purpose of the Study:

    • To investigate the association between lipid-lowering drug use, serum total cholesterol levels, and the risk of nonfatal acute myocardial infarction (AMI) in Japan.

    Main Methods:

    • A case-control study involving 658 AMI cases and 1,274 controls aged 40-79 years.
    • Two definitions of hypercholesterolemia were used, incorporating serum total cholesterol levels and/or current use of hypolipidemic drugs.
    • Unconditional logistic regression analysis adjusted for multiple confounding factors including hypertension, diabetes, smoking, and physical activity.

    Main Results:

    • Untreated hypercholesterolemia was significantly associated with an increased risk of AMI.
    • No significant increase in AMI risk was observed for treated hypercholesterolemia.
    • Among hypercholesterolemic individuals, lower achieved serum total cholesterol levels correlated with progressively reduced odds ratios for AMI.

    Conclusions:

    • While untreated hypercholesterolemia poses a significant AMI risk in the Japanese population, the protective effect of lipid-lowering drug treatment requires further investigation.
    • The achieved level of serum total cholesterol appears crucial in mitigating AMI risk among treated hypercholesterolemic patients.

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