Recent studies have shown that cholesterol lowering in people without heart disease greatly reduces their risk for developing CHD, including heart attacks and CHD-related death. This is true for those with high cholesterol levels and for those with average cholesterol levels.
A 1995 study called the West of Scotland Coronary Prevention Study (WOSCOPS) found that cholesterol lowering reduced the number of heart attacks and deaths from cardiovascular causes in men with high blood cholesterol levels who had not had a heart attack. For 5 years, more than 6500 men with total cholesterol levels of 249 milligrams per deciliter (mg/dL) to 295 mg/dL were given either a cholesterol-lowering drug or a placebo (a dummy pill that looks exactly like the medication), along with a cholesterol lowering diet. The drug that was given is known as a statin (pravastatin), and it reduced total cholesterol levels by 20 percent and LDL ("bad") cholesterol levels by 26 percent.
The study found that in those receiving the statin, the overall risk of having a nonfatal heart attack or dying from CHD was reduced by 31 percent. The need for bypass surgery or angioplasty was reduced by 37 percent and deaths from all cardiovascular causes by 32 percent. A very important finding is that deaths from causes other than cardiovascular disease were not increased, and the overall deaths from all causes were reduced by 22 percent.
In 1998, the results of the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS) showed that cholesterol lowering in generally healthy people with average cholesterol levels reduced their risk for a first-time major coronary event by 37 percent. Study participants had no obvious evidence of CHD and relatively usual total cholesterol levels (average of 221 mg/dL) and LDL-cholesterol levels (average of 150 mg/dL) and lower than usual HDL ("good") cholesterol levels (average of 36 mg/dL for men and 40 mg/dL for women).
This study used a statin drug (lovastatin) along with a low-saturated fat, low-cholesterol diet to lower cholesterol levels. Study participants who received a placebo followed the same low-saturated fat, low-cholesterol diet. After one year, total cholesterol levels in the treatment group were lowered by 18 percent and LDL-cholesterol levels by 25 percent. The risk for a heart attack was reduced 40 percent, unstable angina 32 percent, the need for bypass surgery or angioplasty 33 percent, and cardiovascular events 25 percent. The cholesterol-lowering benefits in this study extended to both men and women as well as older adults. There were no significant differences between treatment and placebo groups in non-cardiovascular disease deaths.