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Opinion

Cholesterol goal lowered for high-risk patients

YOUR DOSE OF MEDICINE - Charles C. Chante MD -
Until recently, the goal for all people was to have LDL – "bad" cholesterol – levels below 100. Heart experts now believe that those at high-risk for a heart attack or those who have recently had a heart attack should try to lower their LDL cholesterol levels to below 70. The recommendation came from a panel of doctors from the National Institutes of Health’s National Cholesterol Education Program. The panel reviewed several recent clinical trials on the benefits of further lowering LDL cholesterol. The new goal presents a challenge to doctors with high-risk patients who may already have trouble getting their LDL levels below 100 through drug treatment, diet and exercise. Consequently many patients may need to begin taking higher doses of statins (cholesterol lowering drugs) to further decrease their cholesterol levels. Researchers are working on combination therapies, such as combining statins with a new drug called Zetia®, which lowers cholesterol levels by interrupting the absorption of LDLs in the intestine. A pill that is a combination of Simvastatin, and Zetia may soon be approved by the Food and Drug Administration. Drugs and combination therapies like these may help patients reduce their LDL levels without increasing their statin dosage. Other patients considered high-risk by the panel include those who have a condition known as acute coronary syndrome and those with cardiovascular disease plus other risk factors such as smoking, diabetes, obesity, high blood pressure or low HDL – "good" cholesterol – levels.

CHOLESTEROL

DRUG ADMINISTRATION

HIGH

LDL

LEVELS

NATIONAL CHOLESTEROL EDUCATION PROGRAM

NATIONAL INSTITUTES OF HEALTH

PATIENTS

SIMVASTATIN

ZETIA

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