Word: ldl
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Dates: during 2000-2009
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...revised guidelines focus on low-density lipoprotein (LDL)--the so-called bad cholesterol. Four years ago, the NCEP recommendations were that patients at high risk of heart attack--including those who have diabetes or already have heart disease--try to get their LDL level under 100 mg/dL. But the guidelines allowed some wiggle room--up to 129 mg/dL. The latest update eliminates the wiggle room for high-risk patients...
...category of patients at "very high" risk--a group that includes heart patients who smoke, diabetics with heart problems and people who are in the hospital for their heart condition. Under the new guidelines, doctors have the option of treating these patients even more aggressively by lowering their LDL cholesterol to less than 70 mg/dL. There was grumbling among some cardiologists who thought that for very-high-risk patients the lower figure should have been made mandatory. It very nearly was, says Dr. James Cleeman, the NCEP coordinator, but the evidence supporting such a move was "just short of conclusive...
...recommendations are likely to sharply increase the use of statin drugs. It's almost impossible to achieve such low LDL levels without the cholesterol-cutting medications, and last week consumer groups complained that the NCEP committee failed to disclose that at least six of its nine members had financial ties to companies that make them. But even the NCEP says the best ways to lower cholesterol are to get more exercise, eat less saturated and trans fats, and maintain a healthy weight. "Patients often think, Since I'm taking a statin, I'm protected," says Dr. Eric Topol, a cardiologist...
Millions of Americans already take a drug to lower their LDL, or bad cholesterol, but if things go Pfizer's way, they may end up adding a pill that raises HDL, the good cholesterol that helps keep arteries clean. A study in the current New England Journal of Medicine reports that the drug torcetrapib boosted HDL levels 46%. When it was combined with the LDL-lowering drug Lipitor, the results were even more dramatic: HDL levels rose 61%, and LDL fell even more than it did with Lipitor alone. But will raising HDL levels mean lower rates of heart disease...
...issue for doctors is not how heart patients get their LDL lowered but that they do it--and fast. The NEJM study showed that the benefits of aggressively lowering LDL cholesterol start appearing in the first month after a patient is hospitalized. That's a lot sooner than anyone expected and a powerful argument for pushing LDL levels as low as they...