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Sunday, March 26, 2006

Lifelong Reduction in LDL Cholesterol Markedly Cuts Risk of Coronary Events

NEW YORK (Reuters Health) Mar 23 - Long-term reductions in LDL cholesterol levels can reduce the risk of coronary heart disease (CHD) by as much as 88%, new research suggests. The findings also indicate a possible new target for lipid-lowering therapy.

Numerous reports suggested a cardioprotective effect for low LDL cholesterol levels, but the impact of lifelong reductions in this lipid parameter was unclear, senior author Dr. Helen H. Hobbs, from the University of Texas Southwestern Medical Center in Dallas, and colleagues note.

To investigate, the researchers looked at the risk of CHD events in nearly 13,000 subjects enrolled in the Atherosclerosis Risk in Communities study. The subjects were followed for 15 years and were divided into two groups based on whether they had sequence variants in a gene called PCSK9, which have been linked to low LDL cholesterol levels.

Among black subjects, 2.6% had nonsense mutations in PCSK9, which were associated with a 28% reduction in LDL cholesterol levels and with an 88% reduced risk of CHD events.

The rate of PCSK9 sequence variations among white subjects was 3.2% and was associated with a 15% drop in LDL cholesterol and with a 47% reduced risk of CHD.

The present findings, along with previous reports, "make PCSK9 an attractive new target for LDL-lowering therapy," the researchers conclude.

In a related editorial, Dr. Alan R. Tall, from Columbia University Medical Center in New York, comments that "the new findings suggest the need to redouble our efforts to reduce LDL cholesterol levels in younger persons by promoting healthy diets and reducing obesity. Even small successes will probably be leveraged for later gains in lowering the risk of cardiovascular disease."



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