Does lowering LDL cholesterol prevent heart attacks and strokes?
Lowering LDL cholesterol is currently the primary focus in preventing Atherosclerosis and Heart Attacks. Most doctors now believe that the benefits of lowering LDL cholesterol include:
- Reducing or stopping the formation of new cholesterol plaques on the artery walls;
- Reducing existing cholesterol plaques on the artery walls;
- Widening narrowed arteries;
- Preventing the rupture of cholesterol plaques, which initiates blood clot formation;
- Decreasing the risk of heart attacks; and
- Decreasing the risk of strokes. The same measures that retard atherosclerosis in coronary arteries also benefit the carotid and cerebral arteries (arteries that deliver blood to the brain).
How can LDL cholesterol levels be lowered?
Therapeutic lifestyle changes to lower cholesterol
Lowering LDL cholesterol involves losing excess weight, exercising regularly, and following a diet that is low in saturated fat and cholesterol.
Medications to lower cholesterol
Medications are prescribed when lifestyle changes cannot reduce the LDL cholesterol to desired levels. The most effective and widely used medications to lower LDL cholesterol are called Statins. Most of the large controlled trials that demonstrated the Heart Attack and Stroke prevention benefits of lowering LDL cholesterol used one of the statins. Other medications used in lowering LDL cholesterol and in altering cholesterol profiles include Nicotinic Acid (niacin), Fibrates such as gemfibrozil (Lopid), resins such as cholestyramine (Questran), and ezetimibe, Zetia.
What are “normal” cholesterol blood levels?
There are no established “normal” blood levels for total and LDL cholesterol. In most other blood tests in medicine, normal ranges can be set by taking measurements from large number of healthy subjects. For example, normal fasting blood sugar levels can be established by performing blood tests among healthy subjects without diabetes mellitus. If a patient’s fasting blood glucose falls within this normal range, he/she most likely does not have diabetes mellitus, whereas if the patient’s fasting blood sugar tests higher than the normal range, he/she probably has diabetes mellitus and further tests can be performed to confirm the diagnosis. Medications, such as insulin or oral diabetes medications can be prescribed to lower abnormally high blood sugar levels.
Unfortunately, the normal range of LDL cholesterol among “healthy” adults (adults with no known coronary heart disease) in the United States may be too high. The atherosclerosis process may be quietly progressing in many healthy adults with average LDL cholesterol blood levels, putting them at risk of developing coronary heart diseases in the future.
Revision date: July 6, 2011
Last revised: by Janet A. Staessen, MD, PhD