Cholesterol-lowering drug combo could reduce risk of heart disease

You might be asking yourself, “What exactly is cholesterol, and how do I keep it in check?” It’s a substance present in everyone’s bloodstream, but if left unmanaged, it can cause serious health issues.

Cholesterol is a type of fat, known as a lipid, present in the blood. It’s a waxy substance that your body needs to build healthy cells, but having too much can result in fatty deposits building up in your blood vessels, which increases your risk of heart disease.

Diet plays a major role in high cholesterol. To keep it under control, reduce foods with saturated fats, such as cheese, biscuits, cakes, butter, pies, sausages, coconut oil, and fatty meats.

Exercise also helps reduce cholesterol. Simple activities, such as taking the stairs instead of the lift, going for a brisk walk, or doing short bursts of activity, such as star jumps at home, can make a difference.

If lifestyle changes alone don’t suffice, medications, such as statins can be prescribed. Scientists have now discovered a powerful combination of two cholesterol-lowering drugs that could prevent thousands of deaths from heart attacks, strokes, and other cardiovascular diseases each year.

The study, published in the Mayo Clinic Proceedings journal, examined data from over 108,000 patients at very high risk of heart attack or stroke, or those who had already experienced one.

The research revealed that using a statin alongside another drug called ezetimibe was significantly more effective than statins alone at lowering levels of ‘bad’ cholesterol (low-density lipoprotein cholesterol, or LDL-C) and reducing mortality.

Statins have long been a cornerstone of heart disease prevention, working by reducing cholesterol production in the liver. Ezetimibe complements this by limiting cholesterol absorption in the gut, especially when statins alone aren’t enough.

The analysis found that patients who received both drugs from the outset had a 19 per cent reduction in overall risk of death, a 16 per cent reduction in cardiovascular-related deaths, and almost 20 per cent fewer major cardiovascular events – including heart attacks and strokes – compared to those who only received high-dose statins.

Globally, cardiovascular disease claims 18 million lives annually, according to the World Health Organisation (WHO). “We estimate that if combination therapy to reduce LDL-C was included in all treatment guidelines and implemented by doctors everywhere for patients with high cholesterol, it could prevent over 330,000 deaths annually among those who have already suffered a heart attack,” said Prof Maciej Banach, lead author of the study and cardiologist at the John Paul II Catholic University of Lublin in Poland.

LDL-C levels also dropped significantly with combination therapy, increasing the likelihood of reaching the ideal target of under 70mg/dL by 85 per cent.

Historically, doctors have tended to prescribe statins first, then assess whether additional medication, such as ezetimibe is needed after a few months. However, this new evidence supports a more proactive approach: start both drugs immediately in high-risk patients.

Co-author Professor Peter Toth added, “This study confirms that combined cholesterol-lowering therapy should be considered right away and should become the gold standard for treating very high-risk patients after an acute cardiovascular event.”

Toth also suggested that this approach could even save healthcare systems money in the long term by avoiding the costly consequences of untreated or poorly managed cardiovascular diseases.

With statins widely available and ezetimibe already used in clinical practice, researchers hope this evidence will lead to a shift in treatment guidelines. Their message to doctors is clear: for patients at the highest risk, don’t wait – start both treatments early and together.

“Our findings emphasise the importance of the adage ‘the lower the better for longer’, but also the equally important ‘the earlier the better’ for treating patients at high risk of cardiovascular conditions to avoid further medical complications and deaths,” Toth said.