Focus on Lipids Care

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How Low Should Serum Cholesterol Levels Go?

KEY POINT

Bayer’s voluntary withdrawal in mid-August of its statin product, cerivastatin (Baycol), because of rhabdomyolysis- associated deaths prompted many patients to begin asking tough questions about the safety of the HMG-CoA reductase inhibitors, and health care professionals initially had few concrete answers. Given that statins are used in patients whose risk of cardiovascular events is 2% or more per year, the possibility of this rare adverse drug event should be viewed as remote indeed. But Baycol’s problems call into the question the aggressive cholesterol-lowering recommendations that have led clinicians to push patients’ low-density lipoprotein (LDL) cholesterol levels further and further down.

SOURCES

Schatz IJ et al. Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study. Lancet. 2001;358:351–5.

Sharrett AR et al. Coronary heart disease prediction from lipoprotein cholesterol levels, triglycerides, lipoprotein(a), apolipoproteins A-I and B, and HDL density subfractions: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2001;104:1108–13.