Targets on cholesterol may not cut heart disease toll

DECADES OF research has failed to show any benefit to setting targets to lower “bad” cholesterol in order to ward off heart disease and death, a new analysis has found.

The study, published in BMJ Evidence Based Medicine yesterday, said that dozens of randomised controlled trials of low-density lipoprotein (LDL) cholesterol reduction through cholesterol reducing drugs such as statins have failed to show any consistent benefit.

The authors reviewed 35 clinical trials comparing treatment with one of three types of cholesterol lowering drugs – statins, ezetimibe, and PCSK9 – with a placebo for a period of at least a year in at-risk patients.

A total of 13 clinical trials met the LDL cholesterol reduction target, but only one reported a positive impact on risk of death and five a reduction in the risk of “events”.

The authors said that setting targets for lowering LDL cholesterol based on risk might seem “intuitive and logical”.

But they added: “Considering that dozens of (randomised controlled trials) of LDL-cholesterol reduction have failed to demonstrate a consistent benefit, we should question the validity of this theory.”

However the study was criticised by other scientists, including Alun Hughes, professor of cardiovascular physiology and pharmacology at UCL, who said the author’s conclusion was based on a “flawed analysis”.

Stuart Pocock, professor of medical statistics at the London School of Hygiene and Tropical Medicine, branded the analysis found in the article as an “extraordinary deception”.