Objectives
The purpose of this study was to estimate the effect of long-term exposure to lower plasma low-density lipoprotein cholesterol (LDL-C) on the risk of coronary heart disease (CHD).
Background
LDL-C is causally related to the risk of CHD. However, the association between long-term exposure to lower LDL-C beginning early in life and the risk of CHD has not been reliably quantified.
Methods
We conducted a series of meta-analyses to estimate the effect of long-term exposure to lower LDL-C on the risk of CHD mediated by 9 polymorphisms in 6 different genes. We then combined these Mendelian randomization studies in a meta-analysis to obtain a more precise estimate of the effect of long-term exposure to lower LDL-C and compared it with the clinical benefit associated with the same magnitude of LDL-C reduction during treatment with a statin.
Results
All 9 polymorphisms were associated with a highly consistent reduction in the risk of CHD per unit lower LDL-C, with no evidence of heterogeneity of effect (I2 = 0.0%). In a meta-analysis combining nonoverlapping data from 312,321 participants, naturally random allocation to long-term exposure to lower LDL-C was associated with a 54.5% (95% confidence interval: 48.8% to 59.5%) reduction in the risk of CHD for each mmol/l (38.7 mg/dl) lower LDL-C. This represents a 3-fold greater reduction in the risk of CHD per unit lower LDL-C than that observed during treatment with a statin started later in life (p = 8.43 × 10−19).
Conclusions
Prolonged exposure to lower LDL-C beginning early in life is associated with a substantially greater reduction in the risk of CHD than the current practice of lowering LDL-C beginning later in life.
Funded by Wayne State University School of Medicine. Dr. Flack is a consultant to Novartis, Medtronic, Back Beat Hypertension, Boehringer Ingleheim, and Daiichi Sankyo; and has received research grants fromNovartis, Medtronic, and the NIH. Dr. Williams is a consultant and speaker for Astellas Healthcare, Inc. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Graham
4 comments:
can I have this post in simply language, preferably with words of no more than 2 syllabuls please : (
Well, I tried reading it, reading it again, reading the link, looking for anyone else's analysis of the study, reading the post yet again. Then it hit me - I needed to lie down in a dark room !
I'll try again later after a couple of whiskies :)
Geoff
Graham posted the item. It's a bit cranial for me, I expect he will give an explanation soon.
Eddie
"can I have this post in simply language, preferably with words of no more than 2 syllabuls please : ("
Can't access the full text but the conflict of interest can clearly be seen.
The aim is to get as many people as possible on statins at a younger age on the pretext it will benefit them in later life, that's if the multitude of complications associated with statins don't get them first.
How about putting children on statins!
"Kids' Cholesterol Tests: Doctors At Odds Over Test Guidance"
http://www.huffingtonpost.com/2012/07/23/kids-cholesterol-tests_n_1694562.html
Graham
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