What did the research discover?
This study examined whether inflammation or cholesterol levels are better predictors of heart disease and death in people already taking statins, a common cholesterol-lowering medication. Researchers analyzed data from 31,245 patients across three major clinical trials: PROMINENT, REDUCE-IT, and STRENGTH. They measured two key factors:
- High-sensitivity C-reactive protein (CRP) – a marker of inflammation.
- Low-density lipoprotein cholesterol (LDL-C) – also known as “bad” cholesterol.
Participants were divided into four groups (quartiles) based on their CRP and LDL-C levels. The researchers then tracked how these factors influenced the risk of major cardiovascular events (like heart attacks and strokes), cardiovascular death, and overall death.
The results showed that higher CRP levels (more inflammation) were strongly linked to a higher risk of heart problems and death, while LDL-C levels had a weaker effect. Compared to those with the lowest CRP levels, those in the highest CRP group had:
- 31% higher risk of major heart events.
- 2.7 times higher risk of death from heart disease.
- 2.4 times higher risk of dying from any cause.
In contrast, higher LDL-C levels did not significantly raise the risk of major heart events and had only a small effect on death risk.
How can I apply this information?
This study suggests that inflammation (measured by CRP) is a bigger threat than cholesterol for people already taking statins. While lowering LDL-C is still important, reducing inflammation may be key to preventing heart attacks and death.
If you are on statins, consider talking to your doctor about:
- Checking your CRP levels to assess inflammation risk.
- Lifestyle changes like a healthy diet, exercise, and quitting smoking, which help reduce both cholesterol and inflammation.
- Additional treatments beyond statins, such as medications that target inflammation.
Since this study is research, more studies are needed to confirm these findings. However, the results suggest that a combined approach—lowering both cholesterol and inflammation—may be the best way to reduce heart disease risk.
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://www.sciencedirect.com/science/article/abs/pii/S0956566323003901?via%3Dihub
