Do patients with low cholesterol need statins too?

STATINS can cut the risk of heart attacks even in those with low- level cholesterol, according to a major review.

researchers say levels of ‘bad’ ldl cholesterol, which furs arteries and causes heart problems, should be as low as possible.

What is considered ‘low cholesterol’ should be cut further to reduce the chances of heart attack and stroke, Harvard researchers say.

The findings should end previous fears that it could be dangerous to have too low a level of cholesterol, doctors say.

Cholesterol is measured in units called millimoles, and at the moment doctors recommend that levels of cholesterol are lowered to 1.8 millimoles per litre of blood using statins.

experts agree that for those who already have a high heart risk, particularly those who have had a heart attack or a stroke, statins are proven lifesavers, slashing the chance of a second attack.

But many doctors are uneasy with what they describe as the ‘over-medicalisation’ of the middleaged, which sees statins doled out ‘just in case’ patients have heart problems in later life.

Previous research has also suggested that taking statins produced diminishing returns.

But the latest study, published in JAMA Cardiology, suggests that there is no lower limit for cholesterol, suggesting people in otherwise good health could benefit from the drugs. It compared trials involving millions of patients, some taking statins alone, while others took them alongside other cholesterol-busting drugs.

research showed some newer drugs, such as evolocumab, could reduce cholesterol levels to

‘Safe and effective’

0.5mmol/l – half a millimole per litre of blood – while further cutting the chances of heart attack and stroke.

dr derek Connolly, a consultant interventional cardiologist at Birmingham City Hospital who was involved in the uK-based trials, said: ‘What this study says is that if you lower the ldl cholesterol to very low levels, it’s safe and effective.

‘If you have cholesterol deposits in the artery, getting cholesterol as low as possible with statins and other drugs ... reduces heart attacks and other events.

‘Therefore we should not have a bottom or lower level of ldl cholesterol in people with heart disease. We should try to get the cholesterol levels as low as possible.’

Kausik ray, professor of public health and consultant cardiologist at Imperial College london, said: ‘These findings are further evidence that there is no such thing as “normal cholesterol”.

‘They add to the growing body of evidence which shows that too much cholesterol is bad for your heart and your general health. When it comes to cholesterol levels, people should know that it’s a case of “lower is better and lowest is best”.’

Cardiovascular disease is Britain’s biggest killer, causing 155,000 deaths each year. every three minutes someone in the uK has a heart attack.

reducing saturated and trans fats in the diet, keeping a healthy body weight, and exercising often are all known to lower levels of ldl cholesterol.

When lifestyle changes are not deemed sufficient, statins are used to reduce the liver’s production of ldl. Because the body needs cholesterol for other tasks, the liver instead takes cholesterol from the bloodstream, therefore lowering levels.