Harvard Health Letter

Changing the cardiovascular prevention game

Results from a large clinical trial may mean a new era of super-low LDL targets and anti-inflammatory strategies.

Commentators on the presidential debates in the fall of 2008 were often asked whether they had spotted any "game changers" — something the candidates said or did that would alter the course of the election. A few days after Election Day, many doctors (especially cardiologists) were talking about a game changer in how we go about preventing heart attacks and strokes.

They were reacting to results from a large clinical trial that showed cardiovascular events were cut in half by taking a powerful statin drug among people whose "bad" LDL cholesterol levels were fine, according to current guidelines, and in no need of lowering. What's more, the results suggested that a test for C-reactive protein (CRP), a marker for inflammation, could be used to flag people who might benefit from this unorthodox use of statins.

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