Can we assume the reductions in cholesterol translate into benefits for health?

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The aorta is the major blood vessels that carries blood from the heart to other parts of the body (except the lungs). Sometimes, individuals can be born with a narrowing of this vessel – a condition known as ‘coarctation of the aorta’. This defect can be repaired surgically. Those with this condition have been noted to be at generally elevated risk of cardiovascular disease including heart disease.

One way to gauge the extent of ‘heart disease’ is to measure the thickness of the walls of coronary artery – known as the ‘coronary intima-media thickness’ (CIMT), assessed via ultrasound performed via a catheter inserted into the vessel via the groin or arm. In a recent study, individuals who had had surgical repair for coarctation of the aorta were treated with a high-dose statin to see what effect it had on CIMT as well as health outcomes [1].

There were 155 individuals in the study, about half of which were treated with 80 mg of atorvastatin (Lipitor) each day, while the other half got no treatment. The trial lasted for 3 years.

The atorvastatin led to a significant reduction in both total cholesterol levels as well as supposedly harmful ‘LDL’ cholesterol. However, those taking atorvastatin saw no reduction in their CIMT measurements compared to those who took nothing.

The researchers also assessed the impact of high-dose atorvastatin on more important measures such as risk of heart attack and stroke and death from these things. There were no benefits to be had here, either.

In this study with this group of patients, long-term reduction in cholesterol did not translate into any benefits at all. This challenges the concept that cholesterol reduction is fundamentally healthy. However, we have much more evidence that challenges the ‘lower cholesterol is better’ paradigm, including the fact that several drugs that successfully reduce cholesterol have been found to have no benefits whatsoever and some of which actually harm health. Dietary modification of cholesterol has been found to be ineffective too.

Should we be too surprised then, that the ‘benefits’ of cholesterol reduction do not always turned out ‘as expected’


1. Luijendijk P, et al. Beneficial effect of high dose statins on the vascular wall in patients with repaired aortic coarctation. Int J Cardiol. 2014 Jun 28 [Epub ahead of print]


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