Statins can lower LDL effectively but its capability of increasing HDL, the good component of cholesterol is very limited. Even patients with statin therapy,are also at increased risk for cardiovascular events if their HDL or good cholesterol level is low-says a new study conducted under the leadership of Dr Richard Karas at Tufts Medical Centre, Boston, MA.

    In their analysis, Karas and colleagues obtained data from 20 randomized controlled clinical trials, including well-known statin studies such as the 4S trial, the Heart Protection Study, the ALLHAT and ASCOT lipid-lowering arms, and JUPITER, among others, to determine whether statin therapy altered the risk associated with low HDL-cholesterol levels. Among the studies, the median baseline and on-treatment HDL-cholesterol levels were 45 mg/dL and 48 mg/dL, respectively, and these levels were similar among statin-treated patients and controls.

    After taking into account LDL-cholesterol levels and age, a 10-mg/dL decrease in HDL-cholesterol levels was associated with 7.1 more MIs per 1000 patient-years in statin-treated patients and 8.3 MIs per 1000 patient-years among healthy controls. The inverse association between HDL-cholesterol levels and MI did not differ statistically between the statin-treated and control patients, and similar results were observed with other cardiovascular disease outcomes.

    This finding indicates treatments directed towards elevation of HDL along with reduction of LDL to be part of routine clinical practice.