Prevention of heart problem
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Preventing Heart Problems
Summary
Despite some confusing findings, maintaining healthy cholesterol levels is crucial to preventing heart attacks and strokes.
Keywords
High cholesterol, Heart problems, Stroke
Article
Barbara V. Howard, PhD, a spokesperson for the American Heart Association (AHA), emphasizes the importance of managing cholesterol to prevent heart attacks and strokes. As the leader of the AHA's council on nutrition, physical activity, and metabolism and the president of MedStar Research Institute, Howard advises starting with diet, exercise, and weight control. If these measures are insufficient, medications may be necessary.
"There is no doubt that lowering cholesterol also reduces stroke risk," Howard states.
Research supports this. Randall Lewington and his colleagues highlight that public health messages should be informed by concrete evidence from randomized trials. These studies reveal that statins, such as Lipitor and Zocor, significantly reduce both coronary events and overall stroke rates across a diverse demographic.
While high cholesterol is a significant risk factor for heart disease-related deaths, its effect on stroke fatalities is less clear. A comprehensive analysis of 61 studies, involving nearly 900,000 participants, revealed that lower total cholesterol strongly protects against heart attack-related deaths in both men and women. The data recorded approximately 34,000 heart disease deaths and 12,000 strokes.
For adults aged 40 to 89, a decrease in total cholesterol by 39 mg/dL (or 1 mmol/L) contributes to a 33% reduction in heart disease deaths. Specifically, those aged 50 to 69 and 70 to 89 saw reductions in mortality risk by 34% and 17%, respectively, with each 1 mmol/L decrease in cholesterol.
According to Sarah Lewington, DPhil, of the University of Oxford, "The message is clear regarding heart disease: if you're at risk or have heart disease, lower cholesterol is beneficial."
However, questions persist about cholesterol's impact on stroke-related mortality. While the protective effects of statins against stroke are well-documented, many observational studies, including recent analyses, fail to establish a robust connection between cholesterol levels and stroke deaths. Some even suggest that low total cholesterol may increase mortality risk in older adults.
"We don't fully understand these findings, and they certainly warrant further research," Lewington remarks. "Nonetheless, evidence from randomized trials shows that reducing cholesterol with statins positively impacts stroke risk. Lowering cholesterol remains beneficial."
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