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High cholesterol has been known to be a risk factor for Coronary Heart Disease for some decades now. But the sorts of medications that we take for cholesterol and what are their possible downsides has also concerned Doctors and patients alike. Well, there's some good news for those who take Statins, and also hope for a new, potential weapon in the war to rid the coronary arteries of life threatening Cholesterol plaques.
A report from the Heart Protection Study published recently in the Lancet has shown that Statins are both safe and effective when taken long term. They followed a group for five years initially and found Statin usage reduced major heart events by 23% in that period. Post study, they followed patients up for a further 11 years and found that patients maintained the lower risk rate, but there was no increase in other health areas such as cancer. So Statins do reduce risk and they don't cause Cancer - and that's got to be reassuring for the millions who take those medications.
But despite Statin usage, some people still have a coronary event, despite "doing all the right things", and some Cardiologists will often shrug their shoulders and say "Blame your genes", which is a good line, but not very helpful!
As most people know, Cholesterol is the name for a family of fats that circulate in the blood stream: and like all good families, most are OK, but some are the "bad guys". In the Cholesterol family, LDL is the bad guy and HDL the good guy. Statins generally work on lowering LDL but don't do a great deal to raise the HDL - although Roscuvastatin does a pretty good job -. Enter cholesteryl ester transfer protein (CETP) inhibitors as cardioprotective agents! These medications lower LDL but also really give a boost to HDL, and the theory then goes that this will reduce the Cholesterol plaque burden within the Coronary arteries where heart attacks are born.
Like many new classes of drugs, the first up effort wasn't the greatest and the Torcetrapib trial was rapidly brought to a premature halt. However, Anacetrapib and Evacetrapib have both been shown to hold great promise in achieving their targets of lowering LDL and raising HDL either alone or in combination with a Statin.
The big question is: will this lead to a reduction in cardiovascular "events" - heart attacks or death? Watch this space!