Blood lipids are a major cause of cardiovascular disease (CVD). Higher levels of LDL cholesterol and lower levels of HDL cholesterol are associated with higher heart disease risk. While this has been known for some time, it is only in recent decades that effective treatments to substantially lower LDL cholesterol have become available.
As a result of CTSU’s randomised trials, most notably the MRC/BHF Heart Protection Study, and worldwide meta-analysis, statins, which substantially lower LDL cholesterol, are now widely used for the primary and secondary prevention of CVD. More recent trials have helped to address important additional questions, such as is more intensive lowering of cholesterol beneficial and do the benefits extend to different patient populations.
More recently, CTSU’s THRIVE trial has shown that a previously widely used drug niacin, which lowers LDL cholesterol and raises HDL cholesterol, had no beneficial effect on major cardiovascular outcomes and was associated with a number of potentially serious side-effects.
Our most recent large randomised trial REVEAL is testing whether there are additional benefits of treating patients with vascular disease who are already receiving statins with a new class (CETP inhibitors) of cholesterol-modifying drug (anacetrapib). The first results are expected in 2016.