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Blood lipids are a major cause of cardiovascular disease. 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, effective treatments to substantially lower LDL cholesterol have only become available in recent decades.

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 cardiovascular disease. More recent trials have helped to address important additional questions, such as whether more intensive lowering of cholesterol is beneficial and whether the benefits extend to different patient populations.

CTSU’s THRIVE trial showed 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, tested whether there were additional benefits of treating patients with vascular disease who are already receiving statins with anacetrapib, a new class (CETP inhibitors) of cholesterol-modifying drug. The results were published in 2017.

Projects within this theme