Chemoprevention of Coronary Heart Disease

Based on a position paper written by John C. LaRosa, M. D.
President, State University of New York Health Science Center
Brooklyn, New York, USA

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Executive Summary

The term chemoprevention refers to the use of drugs to reduce the risk of a disease. The use of cholesterol-lowering drugs to reduce the risk of coronary heart disease and other consequences of atherosclerosis is one example of chemoprevention.

Compelling scientific evidence indicates that cholesterol-lowering drug therapy can reduce the risk of heart attacks by about 30 percent. The benefits of cholesterol reduction have been demonstrated in both men and women, in people with a history of coronary disease and in those with no such history, and in people over the age of 65 as well as in younger people. For best results, cholesterol-lowering drugs should be used in combination with lifestyle changes designed to reduce risk factors for atherosclerosis. Because atherosclerosis is a generalized disease that affects all of the arteries, cholesterol-lowering drug therapy may be more beneficial than localized methods of treating coronary heart disease, such as angioplasty.

It is theoretically possible to reduce blood cholesterol levels substantially through changes in diet and lifestyle, but most people find this very difficult or impossible to achieve. Thus, they may need drug therapy in addition to diet and lifestyle modification.

Recent changes in the official U.S. guidelines for the assessment and treatment of elevated cholesterol levels have more than doubled the number of people eligible for cholesterol-lowering drug therapy. All adults should check with their physicians to learn their overall risk for a heart attack and to find out whether they need to take any action to lower their risk. Those who are eligible for cholesterol-lowering drug therapy should seriously consider this proven form of chemoprevention.

Chemoprevention of Coronary Heart Disease