LDL Cholesterol: How Low Can It Go?

We seldom think about how low the level of LDL cholesterol can go

Often, we talk about lowering the level of our LDL or “bad” cholesterol to stay healthy. But we seldom think about how low can it go? Research has been done to find out whether using a combination of drugs to lower LDL cholesterol to “ultra-low” would provide greater benefits than a modest decrease in the level of bad cholesterol.

What Was The Study?

A manufacturer-funded study, called FOURIER tried to find out about ultra-low levels of LDL cholesterol.

A manufacturer-funded study, called FOURIER, had enrolled over 27,000 people. These people were already taking statin drugs to lower their high level of LDL cholesterol. Half of these people were given injections of evolocumab, a certain drug. The other half were given a placebo, which is a non-active injection.

Evolocumab is a PCSK9 inhibitor, and it works by replicating a genetic variation that is favorable for conditions that would lead to a large reduction in the level of LDL cholesterol.

What Did The Study Find?

The drug given was evolocumab that reduced the risk of cardiovascular diseases.)

An early report of the study called FOURIER found that those people who were taking both statins and evolocumab saw a drastic reduction in LDL cholesterol. This can be further explained as such: in the beginning of the study, the level of LDL cholesterol was 90 mg/dL on an average, and after the therapy, the level fell down to 30 mg/dL right after 48 weeks. This was quite a dramatic result.

Another fact found was that evolocumab reduced the risk of cardiovascular diseases, especially heart stroke and heart attack by almost 15 percent. So, it was proved that out of every 67 people treated with the drug, one person would be an exception. Also, there was no proven reduction in the risk of death in those 2 years of the study.

How Low Can LDL Cholesterol Go?

It was found that with the use of statins that lower cholesterol level, there was a reduction in the risk of cardiovascular diseases when the LDL cholesterol level went low. However, doctors couldn’t come to a definite conclusion how low can the “bad” cholesterol go so that there would still be a significant reduction in the risk of cardiovascular diseases.

This led to re-analysis of the FOURIER study to find how low can the levels of bad cholesterol go to help the human body stay healthy. The new results found were amazing. It was proved that the benefits of lowering the level of LDL cholesterol continued to increase when the levels got even lower. So, fortunately, the “ultra-low” levels of LDL cholesterol reduced the risk of developing cardiovascular diseases such as heart stroke or heart attack even more. There were no safety concerns as well, compared with those people who did not feel the level of LDL cholesterol drop as much.

What Were The Limitations?

There were many limitations of using evolocumab that led people believe in a healthy way of life to decrease cholesterol.)

However, there were certain limitations that were noticed. Since the study FOURIER was done only for two years, researchers couldn’t find if the ultra-low levels of LDL cholesterol decreased the chances of natural death in the long run. There was also the risk of some health problems showing up after the use of evolocumab for years. Also, low LDL cholesterol levels did not prove to bring overall benefits in the health of the people analyzed. One of the biggest limitation was the price of evolocumab as well. Although dramatic drop in LDL cholesterol was noticed, the benefits of evolocumab did not justify the extremely high price of the drug. This was primarily due to the reason that evolocumab therapy did not show any reduction in the risk of natural causes of death.

So, instead of relying on overpriced drugs to lower LDL cholesterol, health experts suggested in reducing the levels of bad cholesterol by taking natural remedies and prevent them as much as possible through healthy living.