All articles tagged with #ldl
A new JAMA study finds measuring apolipoprotein B (apoB) in cholesterol screening may more accurately identify who needs treatment to prevent heart attacks and strokes than LDL or non-HDL cholesterol. The findings align with updated guidelines that emphasize additional tests, like Lp(a), for assessing risk, and suggest apoB can reveal cardiovascular risk even when LDL appears normal.
A Northwestern Medicine study in JAMA finds that apoB testing, which counts harmful cholesterol particles, better guides the decision to intensify cholesterol-lowering therapy than LDL or non-HDL testing, potentially preventing more heart attacks and strokes while remaining cost-effective for U.S. healthcare, based on a computer model comparing three strategies in 250,000 adults.
Researchers identify a new pathway where high dietary cholesterol activates the Ral protein, reducing liver LDL receptors and hindering clearance of LDL cholesterol. Blocking the enzyme cathepsin A (CTSA) with a small-molecule inhibitor stabilized LDL receptors and dramatically lowered blood cholesterol in mouse models, suggesting a novel, statin-independent approach and a potential CTSA-targeted treatment that could move to clinical trials, leveraging an existing CTSA inhibitor with prior human safety data.
A global study of 460 million lipid tests across 17 countries finds South Korea has the lowest LDL ('bad') cholesterol, while Austria and Germany have the highest, with Japan, Australia and Switzerland just below high levels; Turkey and the United States also show below-average levels. Diets rich in fermented foods and legumes and low saturated fat may explain Korea's low levels, while higher animal fats and dairy contribute to higher levels elsewhere; genetics (including familial hypercholesterolemia) also plays a role. Over 1980–2018, cholesterol declined in high-income Western nations due to diet changes and statin use, while many low- and middle-income countries saw increases, especially in Asia; men tend to have higher cholesterol than women.
In a small Phase I study, Verve Therapeutics’ VERVE-102, a one-time mRNA-based gene-editing therapy targeting PCSK9, reduced LDL by up to 62% in the highest-dose group among 35 participants, with no serious safety events aside from a transient mild rise in a liver enzyme; results suggest durable LDL-C lowering, but larger and longer trials are needed for confirmation, and the FDA has granted Fast Track designation.
Eli Lilly’s high-dose, one-time gene-editing therapy VERVE-102 lowered LDL cholesterol by 62% in a Phase 1 trial, with no treatment-related serious adverse events, signaling potential for a single-shot approach to prevent heart disease after Lilly’s $1 billion acquisition of Verve Therapeutics.
Remnant cholesterol, carried by large lipoprotein particles and rich in triglycerides, may drive heart disease more than LDL; it’s rarely measured, and while statins mostly lower LDL, newer drugs plus diet and weight loss can significantly reduce remnant cholesterol and cardiovascular risk.
Researchers screened thousands of compounds in lab-grown human liver cells and identified DL-1, a triazine thiol, that lowers apoB and reduces total cholesterol without causing fatty liver; in mice with humanized livers, a soluble DL-27 version lowered cholesterol metrics, suggesting a safer alternative for severe inherited high cholesterol (familial hypercholesterolemia) beyond current statins.
Experts say the best cholesterol improvements come from a blend of aerobic cardio and resistance (weight) training. Cardio lowers LDL, vLDL and triglycerides while raising HDL function; resistance training also raises HDL about as much as cardio and can improve LDL, vLDL and triglycerides with consistent effort. For meaningful change, aim to burn about 1,000–1,200 calories per week (roughly five 50‑minute cardio sessions) and train 2–3 times weekly for resistance. If you stay consistent, you may see lipid improvements in 4–8 weeks; combining exercise with diet changes yields the biggest LDL reductions (20–30%).
Doctors lowered the LDL cholesterol targets and tied them to an individual’s overall cardiovascular risk, enabling earlier, risk-driven prevention. The guidance uses the PREVENT calculator to decide when lifestyle changes suffice versus when medications should begin, with statins remaining first-line and quicker escalation to ezetimibe or injections if needed. The update also recommends testing lipoprotein(a) and apolipoprotein B, considers targeted imaging in uncertain cases, and calls for earlier screening (adults at 19; kids around 9–11) to detect inherited hypercholesterolemia and start prevention before emergencies.
Regular aerobic exercise, at least 120 minutes per week (about 20 minutes daily), can modestly lower LDL by 3–6 mg/dL and improve triglycerides and HDL; a combination of cardio and strength training yields the strongest cholesterol-related benefits and broader heart-health gains.
High LDL cholesterol raises heart attack and stroke risk, but being lean doesn’t guarantee safety; genetics and saturated-fat intake largely drive LDL levels. Obesity mainly affects other lipids (triglycerides and remnant cholesterol) and is linked to diabetes and high blood pressure, which can make LDL more harmful. Overall cardiovascular risk isn’t determined by LDL alone, so a clinician should assess it—consider NHS checks from age 40 and family history of early heart disease.
Researchers at the Medical University of South Carolina are pursuing a treatment for familial hypercholesterolemia by reducing apoB, the backbone of LDL particles, using human iPSC-derived liver cells to screen about 130,000 compounds. A lead class lowered apoB release and cellular lipid levels in human cells and in humanized mice, bypassing the LDL receptor and potentially helping patients with defective receptors. Further work will clarify the mechanism, safety, and how such drugs could complement existing therapies like statins.
Cardiologists say the only reliable way to know if cholesterol is too high is a blood test. High LDL and low HDL increase heart-disease risk, and new guidelines call for regular lipid screening—from childhood through adulthood (every five years) and measuring lipoprotein(a) at least once. Most people have no early symptoms, so routine testing plus healthy lifestyle choices (diet, exercise, no smoking) are key; signs like chest pain or shortness of breath usually appear only after disease has progressed.
A comprehensive look at common statin myths: large randomized trials show muscle pain is largely a nocebo effect, with true statin-related pain being rare; any diabetes risk from statins is small in absolute terms (low-dose increases ~0.12% per year, high-dose ~1.27% per year) and outweighed by big reductions in heart attacks and strokes; memory loss and liver damage are not proven causal effects and serious liver injury is extremely rare; and the greatest benefit comes from combining statins with healthy lifestyle changes. High-dose statins can lower LDL by about 50% and, when paired with lifestyle improvements, significantly reduce cardiovascular risk.