A new study suggests that a powerful cholesterol-lowering drug may help prevent serious heart problems before they even begin.
Researchers from Mass General Brigham have found that evolocumab, a medication that strongly lowers “bad” cholesterol, can reduce the risk of a first heart attack or stroke in people with diabetes who are at high risk but do not yet have known artery blockage.
Heart disease is the leading cause of death around the world. One of the main drivers of heart disease is a substance called low-density lipoprotein cholesterol, or LDL cholesterol.
This is often called “bad” cholesterol because it can build up in the walls of arteries and form plaque. Over time, this plaque can narrow or block blood flow, leading to heart attacks or strokes.
For many years, doctors have focused on lowering cholesterol mainly in people who already have heart disease. These patients are usually treated with medications such as statins to reduce their risk of future events. However, it has been less clear whether more aggressive treatment should be used earlier, before visible damage to the arteries occurs.
In this study, researchers explored whether earlier and stronger cholesterol reduction could help people who are at high risk but do not yet show clear signs of plaque buildup. The study was presented at a major cardiology conference and published in JAMA.
The researchers looked at more than 3,600 patients with diabetes. These patients were considered high risk because they had lived with diabetes for many years, needed daily insulin, or already had small blood vessel damage. Even though they did not have clear signs of major artery blockage, their risk of heart problems was still high.
Participants were randomly assigned to receive either evolocumab or a placebo. Evolocumab is a type of drug known as a PCSK9 inhibitor. It works by helping the body remove LDL cholesterol from the blood more effectively. Patients in both groups continued their usual treatments, including statins and other medications.
After about one year, the results showed that people taking evolocumab had much lower cholesterol levels. Their LDL cholesterol dropped by about half compared to those who did not receive the drug. This is a large reduction and shows how powerful the medication is.
The researchers then followed the participants for nearly five years to see how many developed major heart problems. These included heart attacks, strokes, or death related to heart disease.
The findings were clear. People who received evolocumab had a 31 percent lower risk of experiencing their first major cardiovascular event compared to those who did not receive the drug. This means that fewer people in the treatment group had serious heart problems during the study period.
Importantly, the drug was also found to be safe. Serious side effects occurred at similar rates in both the treatment and placebo groups. This suggests that the medication was well tolerated.
These results are important because they suggest a new way of thinking about heart disease prevention. Instead of waiting until plaque builds up in the arteries, doctors may be able to reduce risk earlier by lowering cholesterol more aggressively in high-risk individuals.
However, there are still some questions to consider. The study focused on a specific group of patients with diabetes, so the results may not apply to everyone. In addition, evolocumab is more expensive than standard treatments, which may limit its use in some settings.
Further research will be needed to see whether similar benefits are seen in other groups of patients and to understand the long-term effects of early treatment.
Overall, this study provides strong evidence that early and intensive cholesterol lowering can reduce the risk of serious heart problems. It highlights the importance of managing cholesterol levels even before visible artery damage occurs.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and Vitamin K2 could help reduce heart disease risk.
For more information about heart health, please see recent studies about how to remove plaques that cause heart attacks, and results showing a new way to prevent heart attacks, strokes.
Source: Mass General Brigham.
