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Curbing LDL Cholesterol Early Pays Off

Study: Less 'Bad' Cholesterol, Less Heart Disease in People With Certain Gene Mutation
By
WebMD Health News
Reviewed by Louise Chang, MD

March 22, 2006 -- Limiting LDL 'bad' cholesterol from a young age might pay off in less heart disease later on, new research shows.

The finding is based on people with a rare genetic mutation that results in low LDL cholesterol levels. But the results could also be important for people without that mutation, note researcher Jonathan Cohen, PhD, and colleagues.

Cohen's team report that those mutations moderately cut LDL cholesterol and were linked to substantially less risk of heart disease. The study "strongly suggests" benefits from lowering LDL cholesterol at an early age, states an editorial.

The study and editorial appear in The New England Journal of Medicine. Cohen works at the University of Texas Southwestern Medical Center at Dallas.

Gene Mutation Lowered LDL

Cohen and colleagues studied 9,524 whites and 3,363 blacks. All were adults who weren't taking cholesterol-lowering statin drugs and had no history of heart disease.

Participants were 45-64 years old when the study started in 1987. They were followed for 15 years and lived in four communities: Jackson, Miss.; Minneapolis; Forsyth County, N.C.; and Washington County, Md.

Nearly 3% of blacks and whites had mutations of the PCSK9 gene. Those mutations were linked to a 28% drop in average LDL cholesterol for blacks and a 15% drop in LDL cholesterol for whites.

Hearty Perks

Blacks and whites tended to have different PCSK9 gene mutations. All resulted in lower LDL levels and a drop in heart disease risk.

Blacks with the gene mutations were 88% less likely to develop heart disease than their peers without the mutations. Whites with the mutations were nearly half as likely to develop heart disease as those lacking the mutations.

Participants weren't necessarily in tip-top shape. Smokers, overweight people, and those with diabetes or high blood pressure were included in the study. No one was asked to upgrade their diets or lifestyles.

The PCSK9 gene might make a good target for new cholesterol drugs, the researchers note. They add that cholesterol-lowering statin drugs might counter the mutations' effects, but Cohen's team didn't test that theory in this study.

Other genes are also important in handling LDL levels, the researchers note in a news release.

Lifelong Effort

What about people without those gene mutations? The take-home message for them may be to curb LDL starting early in life, states a journal editorial.

"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," writes editorialist Allan Tall, MB, BS.

"Even small successes will probably be leveraged for later gains in lowering the risk of cardiovascular disease," he adds.

Tall, who didn't work on Cohen's study, directs the Specialized Center of Research in Molecular Medicine and Atherosclerosis at New York's Columbia University Medical Center.

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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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