Cardiologists generally agree that people with heart disease benefit from taking statins, though they may disagree about the usefulness of these drugs for preventing heart attacks in healthy people. (You can read more about that here.) But how much does lowering LDL dramatically help a person who has had a heart attack?
Lowering LDL Below 70?
Cardiologists have focused in the past on lowering LDL cholesterol as much as possible. They had evidence that higher levels of LDL increased the risk of heart attacks, and found that bringing LDL down below 100 mg/dL could help prevent heart attacks in people at high risk. Doctors tried to get LDL cholesterol levels below 70 for those at super high risk.
Investigators wondered whether people already taking statins would do better if their treatment could be intensified so that LDL cholesterol levels drop below 70. They studied records of patients in a large health care organization in Israel between 2009 and 2013. More than 30,000 people with heart disease met the criteria of taking a statin at least 80 percent of the time. Although their ages ranged from 30 to 84, the average age was 67.
What Are the Results of Taking Statins?
In this large group of patients, 29 percent achieved low LDL cholesterol levels by taking a statin (below 70). Roughly half (53 percent) had moderate success, with LDL levels between 70 and 100. The remaining 18 percent had LDL cholesterol over 100 even though they took a statin on a regular basis.
Statistical analysis showed no significant difference between low and moderate levels of LDL cholesterol when it came to the risk of a heart attack or stroke. There was a significant difference between those with moderate and high levels, however. Those with moderate levels of LDL were only 89 percent as likely to have a cardiovascular complication as those with high levels.
In conclusion, these researchers found that lowering LDL cholesterol to between 70 and 100 is protective. Going lower than 70 does not offer additional benefit.
