Low Density Lipoprotein Cholesterol and Coronary Heart Disease – Lower is Better

Abstract

Studies have consistently shown that coronary heart disease (CHD) risk is correlated closely with low density lipoprotein (LDL) cholesterol levels. The lower the LDL cholesterol, the lower the cardiovascular (CV) risk; however, there is a question over how much LDL cholesterol lowering is low enough and what supporting evidence there is for this. This article reviews recent evidence in support of the notion that ‘lower LDL cholesterol is better,’ drawing on revised guidelines from the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Data are presented to show that, in clinical practice, the majority of patients are treated suboptimally with traditional single inhibition statin monotherapy. In contrast, ezetimibe/simvastatin, a dual inhibitor of both cholesterol absorption and production, represents a more effective approach to treatment, allowing more patients to meet or exceed their LDL cholesterol goals.