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Antioxidants, Drugs Battle It Out Against Heart Disease


WebMD Health News

Nov. 28, 2001 -- Cholesterol-lowering drugs and antioxidants have been battling it out to see who reigns supreme in the fight against heart disease. But findings raise a serious concern about antioxidants.

Drugs that lower cholesterol are known to help keep heart disease at bay by preventing blockage in arteries. But antioxidants are thought to have some benefit as well. So researchers wanted to see if giving it the old one-two punch might be the best approach.

Cholesterol can be a tricky thing to understand when it comes to heart disease. You take the good, you take the bad, you take them both, and there you have the facts of heart disease.

LDL cholesterol is the bad guy. High levels of LDL increase the chance that you'll develop heart disease. In order to improve your fight against heart disease, your LDL should be less than 100, according to cholesterol guidelines released earlier this year. But once your LDL creeps over 130, you are getting into the borderline high range. At 160, you've gone over the edge.

But there's a good guy in this story, too. Higher levels of HDL cholesterol can actually help prevent heart disease and blocked arteries. Optimal levels of HDL are 60 and up. If your HDL is at least 40, then you're doing OK, but lower than this and you need to talk to your doctor about how to bring it up.

B. Greg Brown, MD, PhD, and colleagues put cholesterol-lowering drugs and antioxidants to the test. Brown is with the department of medicine at the University of Washington in Seattle.

Would drugs or antioxidants alone improve cholesterol? Would using both of them together do even better?

The researchers looked at 160 people who had heart disease as well as high LDL cholesterol levels and low HDL. People took antioxidants alone, cholesterol-lowering drugs alone, or both. They also compared these results to people taking a placebo.

The antioxidants consisted of 800 IU of vitamin E, 1,000 mg of vitamin C, 25 mg of natural beta-carotene, and 100 micrograms of selenium.

The cholesterol-lowering drugs that were used were Zocor and niacin. Zocor belongs to a class of drugs called "statins," which also include Lipitor and Pravachol.

The researchers found that antioxidants had no effect on cholesterol levels when taken alone. However, Zocor and niacin together improved cholesterol significantly. LDL fell 42% while HDL rose 26%.

The results of the study are published in the Nov. 29 issue of The New England Journal of Medicine.

The researchers then looked at each person's blood vessels in the heart to see how much blockage there was -- keeping in mind that each participant in the study was already known to have heart disease.

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Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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