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To Reduce Your Heart Attack Risk, Get Cholesterol Down

People with a high heart attack risk benefit from lowering their LDL cholesterol. How can you get your LDL under control most effectively?

Lowering dangerous LDL cholesterol is a primary focus for people who want to lower their  heart attack risk. That’s been dogma for decades, and it has just been re-affirmed.

Can You Lower Your Heart Attack Risk Without Taking a Statin?

Sometimes people who have side effects on statins wonder if getting their cholesterol down through other means will work just as well. Until recently, doctors did not have an evidence-based answer to that question.

Now, a meta-analysis compared statins and other cholesterol lowering therapies. The aim was to see how much such treatments reduced cardiovascular events such as heart attacks and strokes.

How Study Volunteers Lowered Their Cholesterol:

There were 49 trials in the meta-analysis with 312,000 volunteers. The studies included in the analysis used various methods to lower cholesterol: first, statins such as Crestor or Lipitor; second, diet or drugs like Questran or Welchol; third, medicines like fibrates or niacin; and fourth, the new PCSK9 inhibitors.

What Matters Most:

What mattered most for preventing heart attacks and similar problems was how much people managed to lower their LDL cholesterol. The authors point out that statins are a relatively easy way for most people to move that needle a lot. That is why doctors tend to be so enthusiastic about them. PCSK9 inhibitors may end up having a big effect, but we won’t know for sure until the studies on these new drugs are completed in 2017. In the meantime, the main message is to keep LDL cholesterol under control to reduce stroke and heart attack risk.

JAMA, Sept. 27, 2016

You can find more information on cholesterol-lowering drugs and non-drug approaches to getting cholesterol down in our Guide to Cholesterol Control and Heart Health. Even though cholesterol is not the only heart attack risk factor, the research consistently shows it is important.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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