Lowering Cholesterol to Prevent Heart Disease

What Does the Research Say?

Several studies have looked at the effects of lowering cholesterol to prevent heart disease. These research studies have shown that the progress of atherosclerosis may be halted by lowering cholesterol. In some cases, it may even be reversed.
This results in fewer people developing and dying from heart disease. It also lowers the number of people with heart disease who have another heart attack or die from heart disease. Examples of these studies include the:
  • Framingham Heart Study
  • Scandinavian Simvastatin Survival Study (4S)
  • Cholesterol and Recurrent Events (CARE) Study.
Framingham Heart Study
The Framingham Heart Study established that high blood cholesterol is a risk factor for coronary heart disease. Results of the Framingham study showed that the higher the cholesterol level, the greater the risk for heart disease. On the other end of the spectrum, heart disease is uncommon when total cholesterol levels are below 150 milligrams per deciliter (mg/dL).
4S Study
A 1994 study called the Scandinavian Simvastatin Survival Study (also known as 4S) found that lowering cholesterol can prevent heart disease and heart attacks and reduce related deaths in men and women who already have heart disease and high cholesterol.
For more than five years, more than 4,400 patients with heart disease and total cholesterol levels of 213 mg/dL to 310 mg/dL were given either a cholesterol-lowering medication or a placebo (a "sugar" pill that looks exactly like the medication but contains no active ingredients). The drug they received was known as a statin, and it reduced total cholesterol levels by 25 percent and LDL cholesterol levels by 35 percent.
The study found that in those receiving statin drugs:
  • Deaths from heart disease were reduced by 42 percent
  • The chance of having a nonfatal heart attack was reduced by 37 percent
  • The need for coronary artery bypass surgery (CABG) or angioplasty was reduced by 37 percent.
A very important finding to emerge from this study was that deaths from causes other than cardiovascular disease were not increased, and so the 42 percent reduction in heart disease deaths resulted in a 30 percent drop in overall deaths from all causes.
The 4S researchers claimed that the following benefits could be expected if doctors were to treat their patients with heart disease for the same five-year period and lower cholesterol to the same extent. For every 1,000 patients:
  • Forty people would be saved out of the 90 who would otherwise die from heart disease
  • Seventy of the expected 210 nonfatal heart attacks would be avoided
  • Heart procedures (such as heart bypass surgery) would be avoided in 60 of the 210 patients who would be expected to require these procedures.
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