Cholesterol drug dilemma
A current topic of hot debate in the medical field is the efficacy of cholesterol-lowering drugs in prolonging life. Britain has one of the highest rates of heart disease in the world; every year over 300 000 people suffer from heart attacks and around 170 000 people die from an attack. One of several factors linked with increased risk of heart disease is high blood levels of cholesterol, a fatty substance which forms part of a biological group called sterols. Until recently, drug therapy for people with high blood cholesterol levels has been a subject of controversy in the medical field, mainly because clinical trials have failed to show sufficient evidence of improved survival after taking the drugs. In fact, some reviews of clinical studies on cholesterol-lowering drugs suggest that the survival rate (in terms of gross numbers) is not improved because the observed reduction of deaths from coronary heart disease (CHD) is offset by an apparent increase in non-cardiac mortality, including cancer and violent deaths. During the past few years, medical journals have published epidemiological studies (long term studies comparing different population groups) that indicate that certain cholesterol lowering drugs, particularly the newest class called statins, do in fact have beneficial effects in terms of prolonging life and reducing the chance of further secondary attacks. The latest of these studies, the Cholesterol and Recurrent Events (Care) study, was published in the New England Journal of Medicine only last month. It was carried out by US researchers from Harvard Medical School who found that the Bristol-Myers Squibb (BMS) drug pravastatin reduced the chance of a second heart attack for CHD patients with normal cholesterol levels by 25 per cent.Cholesterol plays several vital roles in the body. It is a structural component of all cell membranes, and is necessary for the formation of certain hormones, vitamin D and bile acids (which solubilise fats in the small intestine). However, the role that draws more public attention is its part in the formation of atheromatous lesions in arterial walls, which constitute an underlying cause of coronary heart disease. Atheromas are the blockages that build up over a number of years in blood vessels, consisting of a variable combination of lipids (fats), complex carbohydrates, blood and blood products, fibrous tissue and calcium deposits. These blockages may eventually interfere with blood circulation, leading to CHD. High blood cholesterol constitutes a small but significant part of the pathological process behind atheroma formation in the blood vessels (atherosclerosis). Credited to the Royal Society of Chemistry
