Word: ldl
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Dates: during 2000-2009
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Pravachol and Lipitor are both statins--a group of cholesterol-lowering drugs that are widely used in the treatment of heart disease. Doctors have long known that Lipitor lowers the level of LDL, the so-called bad cholesterol, more than Pravachol does. Both groups of patients in this study--to be published in the April 8 issue of the New England Journal of Medicine but released a few weeks early--had their LDL levels reduced below 100 mg/dL--the target currently recommended by the National Heart, Lung, and Blood Institute (NHLBI) for folks who have heart disease or diabetes. The Lipitor...
What experts take from this is not that Lipitor is superior but that the official LDL targets may not be low enough. "LDL lowering is the name of the game," says Dr. James Cleeman, coordinator of the National Cholesterol Education Program at the NHLBI. "I don't think you can conclude that one brand is better than the other." Cleeman's group, which sets U.S. guidelines, is preparing a scientific paper to explain how doctors can best use the latest results in their practice...
...knows yet how low LDL levels should go. Most likely, there is a point of diminishing returns where going any lower isn't worth the effort or the risk of side effects. "I'm currently treating patients with heart disease at LDL goals of 70 mg/dL," says Dr. Robert Eckel, chair of the American Heart Association's Council on Nutrition, Physical Activity and Metabolism. He says that if he can do that with Pravachol, he uses Pravachol. If not, he uses one of the other five statins currently available--depending on his patient's condition and insurance requirements...
...thought of heart attacks as primarily a plumbing problem. Over the years, fatty deposits would slowly build up on the insides of major coronary arteries until they grew so big that they cut off the supply of blood to a vital part of the heart. A complex molecule called LDL, the so-called bad cholesterol, provided the raw material for these deposits. Clearly anyone with high LDL levels was at greater risk of developing heart disease...
Physicians still don't know for sure how inflammation might cause a plaque to burst. But they have a theory. As the level of LDL cholesterol increases in the blood, they speculate, some of it seeps into the lining of the coronary arteries and gets stuck there. Macrophages, alerted to the presence of something that doesn't belong, come in and try to clean out the cholesterol. If, for whatever reason, the cytokine signals begin ramping up the inflammatory process instead of notching it down, the plaque becomes unstable. "This is not about replacing cholesterol as a risk factor," Ridker...