What did the research discover?
This study looked at how inflammation and cholesterol levels affect the risk of future heart disease and death in people who are already taking statins (cholesterol-lowering medications). Researchers analyzed data from 31,245 patients in three large clinical trials (PROMINENT, REDUCE-IT, and STRENGTH) to see whether high-sensitivity C-reactive protein (CRP) (a marker of inflammation) or low-density lipoprotein cholesterol (LDL-C) (a marker of cholesterol levels) was a better predictor of heart-related health risks.
The findings showed that inflammation was a stronger predictor of heart problems and death than cholesterol levels. Patients with higher CRP levels were significantly more likely to experience major cardiovascular events (like heart attacks and strokes), cardiovascular death, and death from any cause compared to those with lower CRP levels. Specifically, those in the highest CRP group had:
- 31% higher risk of major cardiovascular events.
- 2.68 times higher risk of cardiovascular death.
- 2.42 times higher risk of death from any cause.
In contrast, cholesterol levels (LDL-C) were not strongly linked to these risks. People with higher LDL-C had only a 7% increase in major cardiovascular events (which was not statistically significant) and a 27% higher risk of cardiovascular death (which was much lower than the risk from inflammation).
How can I apply this information?
If you are taking statins to lower your cholesterol, this study suggests that reducing inflammation might be just as important—if not more important—than lowering cholesterol alone when it comes to preventing heart disease and death. Even if your cholesterol is well-controlled, high levels of inflammation could still put you at risk for heart problems.
Doctors may need to consider additional treatments beyond statins, such as anti-inflammatory therapies or lifestyle changes that reduce inflammation, to better protect against heart disease.
Because this study is research, more studies are needed to confirm these findings. However, it highlights the importance of monitoring inflammation levels (CRP) along with cholesterol levels and suggests that a combined approach—lowering both cholesterol and inflammation—might be the best way to reduce the risk of heart disease.
Source:
Ridker PM, Bhatt DL, Pradhan AD, Glynn RJ, MacFadyen JG, Nissen SE. Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials. The Lancet. 2023 Apr 15;401(10384):1293-301. https://pubmed.ncbi.nlm.nih.gov/36893777/
