Cardiology Great Quotes

WHAT ABOUT PLAQUE? Okay, so maybe statin drugs don’t cut the risk of dying, except possibly in middle-aged men with previous histories of heart disease (and even then the effect is modest). But what about plaque? Doesn’t aggressive lowering of LDL cholesterol at least reduce plaque? Well, no. A study published in the American Journal of Cardiology in 2003 used electron beam tomography to evaluate plaque in 182 patients after 1.2 years of treatment with either statins alone or statins in conjunction with niacin.32 And yes, just like in many other studies, cholesterol did indeed go down in those patients treated with cholesterol-lowering medication. But plaque? Sorry. The authors wrote, “Despite the greater improvement in [cholesterol numbers] … there were no differences in calcified plaque progression.” In fact, subjects in both groups had—on average—a 9.2 percent increase in plaque buildup. “[W]ith respect to LDL cholesterol lowering, ‘lower is better’ is not supported by changes in calcified plaque progression,” concluded the authors.