Cutting cholesterol

Cutting cholesterol PEOPLE suffering from coronary heart disease (CHD) can now hope for better survival chances, thanks to a new drug called "simvastatin" which can bring down the level of blood cholesterol. This drug succeeded in a largescale clinical trial conducted by a Scandinavian team of researchers (The Lancet, Vol 344, No 8934).

High cholesterol in blood serum causes arterial blockages and has been the target of attack by many researchers over the past decade. The clinical trials of several drugs in the past suggested that any decrease in the death rate through a drop in cholesterol levels was offset by an increase in the risk of diseases, including cancer, and even suicide.

But simvastatin interferes with an enzyme in the liver which is essential for synthesising cholesterol. When this enzyme is blocked, the liver produces chemicals which force out cholesterol from the bloodstream, resulting in a drop in serum cholesterol levels.

The Scandinavian team led by Terje Pedersen of Oslo University's Aker Hospital in Norway studied the effect of simvastatin on more than 4,400 CHD patients in Norway, Sweden, Finland, Iceland and Denmark, who had elevated levels of cholesterol and were at a high risk of cardiac death. They were randomly assigned to treatment with 20 mg of simvastatin, or a placebo with no simvastatin. They were tested for adverse effects after 6 weeks, 12 weeks, and 6 months and every 6 months thereafter for 5 years 4 months.

The researchers have reported that apart from an overall 30 per cent reduction in death from heart disease, the drug also reduced hospitalisations due to heart attacks by 30 per cent and lowered the need for bypass surgeries by 37 per cent. The report also claims that long-term treatment with simvastatin is safe and that side-effects evident in other drugs were missing.

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