Heart attacks and strokes often seem to happen suddenly, but they usually develop slowly over many years. Damage builds up inside the arteries long before symptoms appear. Because of this, doctors have been searching for ways to prevent heart disease earlier, especially in people who are at high risk.
A new study from Mass General Brigham, published in JAMA and presented at the American College of Cardiology’s Annual Scientific Session, offers promising evidence. It shows that a powerful cholesterol-lowering drug called evolocumab may reduce the risk of first-time heart events in people with diabetes, even before they show clear signs of artery disease.
Cholesterol is a fatty substance in the blood. While the body needs some cholesterol, too much of the “bad” type, known as LDL cholesterol, can be harmful. It can stick to the walls of arteries and form plaques. Over time, these plaques can narrow or block blood flow, leading to heart attacks or strokes.
Most people who are at risk are treated with statins, which help lower cholesterol levels. However, statins may not always be enough, especially for people with conditions like diabetes, which already increase the risk of heart disease.
Evolocumab is part of a newer group of medicines called PCSK9 inhibitors. These drugs help the body remove more LDL cholesterol from the blood. They are usually given by injection and are often used for people who already have heart disease.
In this study, researchers wanted to see if using this drug earlier could prevent problems before they start. They studied 3,655 people with diabetes who were considered high risk but did not yet have significant artery blockage.
Participants were randomly placed into two groups. One group received evolocumab injections every two weeks, while the other received a placebo. All participants continued standard treatments such as statins.
After 48 weeks, the difference in cholesterol levels was clear. Those taking evolocumab had much lower LDL cholesterol levels compared to those who did not receive the drug.
More importantly, over a period of nearly five years, the group taking evolocumab had a much lower chance of experiencing their first major heart event. This included heart attacks, strokes, or death related to heart disease. The risk was reduced by 31 percent.
The results suggest that lowering cholesterol more aggressively at an earlier stage may help prevent serious outcomes. This is a shift from traditional practice, which often focuses on treating patients after disease has already developed.
The study also found that the treatment was generally safe, with similar rates of serious side effects in both groups.
Looking at the findings, this research provides strong evidence that earlier intervention may be beneficial. The randomized design and large number of participants make the results reliable. However, the study focused only on people with high-risk diabetes, so more research is needed to see if the same approach works for other populations.
In conclusion, this study highlights the importance of early prevention in heart health. By lowering cholesterol before major damage occurs, it may be possible to reduce the number of heart attacks and strokes in the future. This could lead to a change in how doctors treat high-risk patients.
If you care about heart health, please read studies about how vitamin D influences cholesterol levels, and what we know about egg intake and heart disease.
For more health information, please see recent studies about best supplements for heart disease prevention, and wild blueberries can benefit your heart and brain.
Source: Mass General Brigham.
