Blood lipids are a major cause of cardiovascular disease. It has been known for some time that higher levels of LDL ("bad") cholesterol and lower levels of HDL cholesterol are associated with higher heart disease risk, but effective treatments to substantially lower LDL cholesterol have only become available in recent decades.
As a result of our randomised trials, such as the MRC/BHF Heart Protection Study, and worldwide meta-analysis, statins, which substantially lower LDL cholesterol, are now widely used for the primary and secondary prevention of cardiovascular disease. More recent trials have helped to address important additional questions, such as whether more intensive lowering of cholesterol is beneficial and if the benefits extend to different patient populations.
The THRIVE trial showed that a previously widely used drug niacin, which lowers LDL cholesterol and raises HDL cholesterol, had no beneficial effect on major cardiovascular outcomes and was associated with potentially serious side-effects.
Our most recent large randomised trial REVEAL found that adding anacetrapib (a CETP inhibitor cholesterol-modifying drug) to statin therapy reduces the incidence of cardiovascular events for high risk patients.