Lowering LDL cholesterol – often called “bad” cholesterol – is one of the most important steps in preventing heart disease and stroke.
High levels of LDL can block blood flow by building up in the arteries, leading to heart attacks and strokes. Doctors around the world agree that reducing LDL cholesterol can save lives.
In a new editorial published in Trends in Cardiovascular Medicine, researchers from Florida Atlantic University say that doctors should use the strongest doses of the most powerful statin drugs to lower LDL cholesterol.
These high-potency statins are rosuvastatin and atorvastatin. The researchers believe that these drugs should be the main medicine used alongside healthy lifestyle changes for treating heart disease.
While lifestyle changes like eating well, staying active, and quitting smoking are always important, many people still struggle with risk factors.
About 40% of adults in the U.S. have metabolic syndrome, which includes problems like obesity, high blood pressure, abnormal cholesterol levels, and insulin resistance. These conditions raise the risk of heart disease, even if a person hasn’t yet had a heart attack or stroke.
The researchers also point out that only about one in five Americans gets enough physical activity each day. But it’s never too late to start – even older adults can benefit from becoming more active.
The authors reviewed many large clinical trials and studies. They concluded that statins, especially rosuvastatin and atorvastatin, have the strongest evidence for helping both men and women, including older people, reduce their risk of heart problems.
Because many patients stay on the dose they are first given, the researchers recommend starting with the highest dose of these statins and lowering it later if needed. They also noted that using statins along with aspirin can be even more effective.
Most people who already had a heart attack or stroke (secondary prevention) should take both. For those who haven’t (primary prevention), doctors should carefully weigh the risks and benefits before adding aspirin.
Dr. Charles Hennekens, the lead author of the editorial, said that other medicines should only be added after patients have tried the strongest statins. He emphasized that statins have the most convincing evidence of success among all heart medications.
The researchers shared some cautious opinions on other cholesterol-lowering drugs. For example, the drug ezetimibe added only small benefits in the IMPROVE-IT trial.
Evolocumab, another drug, helped some people in the FOURIER trial, but only those who already had genetic cholesterol disorders and were taking the highest dose of statins. Another ongoing study, ILLUMINATE, is testing evolocumab in people at high risk who haven’t yet had heart problems.
The editorial also discussed omega-3 fatty acids. While earlier studies seemed positive, later ones didn’t show benefits, possibly because many participants were already taking statins.
One exception was the REDUCE-IT study, where a purified omega-3 product called icosapent ethyl reduced major heart events by 25% when added to statins. That means treating 21 people with this combination could prevent one serious heart problem.
The researchers ended their article with a reminder from Benjamin Franklin: “An ounce of prevention is worth a pound of cure.” Making smart choices early can help people live longer, healthier lives.
If you care about heart health, please read studies that yogurt may help lower the death risks in heart disease, and coconut sugar could help reduce artery stiffness.
For more information about health, please see recent studies that Vitamin D deficiency can increase heart disease risk, and results showing vitamin B6 linked to lower death risk in heart disease.
Copyright © 2025 Knowridge Science Report. All rights reserved.
