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Cholesterol lowering and morbidity and mortality
1Tulane University Medical Center, New Orleans, Louisiana, USA.
Insights
Lowering cholesterol effectively prevents coronary atherosclerosis progression. Despite concerns, analysis of clinical trials and population studies shows cholesterol lowering does not increase noncardiovascular mortality.
Area of Science:
- Cardiovascular Medicine
- Atherosclerosis Research
- Lipid Metabolism
Background:
- Circulating cholesterol is a known cause of coronary atherosclerosis.
- Cholesterol-lowering interventions are proven to slow atherosclerosis progression.
Purpose of the Study:
- To investigate the potential link between cholesterol lowering and noncardiovascular mortality.
- To address concerns raised by primary prevention trials and population studies.
Main Methods:
- Analysis of existing clinical trial data.
- Review of observational population studies.
Main Results:
- Data from clinical trials did not support a link between cholesterol lowering and increased noncardiovascular mortality.
- Observational data also failed to demonstrate a causal relationship.
Conclusions:
- Concerns regarding cholesterol lowering causing noncardiovascular mortality are not supported by scientific evidence.
- Cholesterol lowering remains a safe and effective strategy for managing coronary atherosclerosis.
Abstract:
Circulating cholesterol is causative in coronary atherosclerosis. Moreover, cholesterol lowering has been demonstrated to prevent the progression of atherosclerosis. Concern has been expressed, based on primary prevention trials and population studies, that cholesterol lowering might cause noncardiovascular mortality. When carefully analyzed, however, neither clinical trial data nor observational data supported this concern.