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expert reaction to meta-analysis of treatment options to reduce cholesterol in those with already low cholesterol

Researchers evaluate the efficacy and safety of further lowering low-density lipoprotein cholesterol in patient populations presenting with very low levels of cholesterol, in a new study, in JAMA Cardiology.


Prof Kausik Ray, Professor of Public Health and Consultant Cardiologist at Imperial College London, said:

“The paper is not a single study but a meta-analysis which is a comparison / amalgamation statistically of large trials. The quality of the study is good and methods appropriate for this type of work. It’s important as it compares three different ways of lowering LDL, or bad cholesterol, in those who traditionally would not be considered to have high cholesterol. It shows it doesn’t matter how you lower LDL, lower is better and the benefit is related to how much you lower LDL. It also shows that lower LDL is not associated with harm. People have confused diets in low fats and lack of benefit versus therapeutically lowering LDL. There is unequivocal large scale evidence that lower is better, period!

“These findings are further evidence that there is no such thing as ‘normal cholesterol’ and add to the growing body of evidence which shows that too much cholesterol is bad for your heart and your general health. When it comes to cholesterol levels, people should know that it’s a case of ‘lower is better and lowest is best’.”


* ‘Efficacy and Safety of Further Lowering of Low-Density Lipoprotein Cholesterol in Patients Starting With Very Low Levels’ by Marc Sabatine et al. published in JAMA Cardiology on Wednesday 1 August.


All our previous output on this subject can be seen at this weblink:


Declared interests

Prof Kausik Ray: Professor Ray works as an investigator, PI or advisor with multiple pharmaceutical companies developing cholesterol-lowering medications. He is also part of the European Atherosclerosis Consensus Panel and represents the British Cardiovascular Society as an advisor to NICE.

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