All articles tagged with #ldl cholesterol
A six-month trial of 786 adults with abdominal obesity found that adding one avocado daily to their diet reduced LDL cholesterol by about 49 nmol/L (roughly 4% lower risk of heart disease). The effect is attributed to avocado's monounsaturated fats, fiber, and phytosterols. Experts say avocados should be part of a broader heart-healthy lifestyle (vegetables, fruits, whole grains, lean proteins, exercise) and not a magic bullet.
HDL is the “good” cholesterol, but simply trying to raise it isn’t straightforward or reliably protective on its own. Experts say to focus on treating underlying health issues (like insulin resistance, obesity, and high blood pressure) and maintain core health habits—nutrient-rich diet, regular exercise, adequate sleep, and not smoking. HDL may rise as a byproduct of these changes, but some people are genetically predisposed to low HDL and still have cardiovascular risk. There are no proven foods or medications that dramatically raise HDL; optimizing LDL remains the primary strategy to lower heart disease risk.
The FDA approved Lipfendra (enlicitide), the first oral PCSK9 inhibitor for high cholesterol and heterozygous familial hypercholesterolemia. In trials, Lipfendra lowered LDL cholesterol by about 56–59% versus placebo, mainly in patients already on statins, but there’s no head‑to‑head comparison with statins yet. It can be used alongside statins or other lipid drugs when LDL remains above goal, offering a pill alternative to injectable PCSK9 inhibitors. However, it’s approved only for adults, has a stringent morning-on-empty-stomach regimen, and more cardiovascular outcomes data are still being gathered, so doctors will tailor its use to patients who need additional LDL lowering beyond maximally tolerated statin therapy.
A zero coronary calcium score often signals low short-term risk, but in a CARDIA analysis of young-to-middle-aged adults, higher cumulative LDL-C exposure over the prior 25 years predicted more cardiovascular events even when CAC was zero. At age ~50, those in the highest LDL-C exposure quartile had about a 3.36-fold higher adjusted risk than the lowest, though absolute event rates remained modest (roughly 3.9% vs 1.3% over about a decade). This means zero CAC is reassuring but must be interpreted in the context of age, sex, family history, and lifelong LDL exposure.
A systematic review and meta-analysis of nine randomized trials (6,355 participants) found inclisiran—given by subcutaneous injection at baseline, 3 months, then every six months—produces about a 49% greater LDL-C reduction versus placebo, with consistent benefit across backgrounds of lipid-lowering therapy including statins; its twice-yearly dosing may aid adherence and help statin-intolerant patients, though long-term cardiovascular outcomes are still being studied in ongoing ORION-4 and VICTORION-2P trials, and clinicians see inclisiran as complementary to statins rather than a replacement, with future work needed on safety, cost-effectiveness, and equitable access.
FDA-approved enlicitide is an oral pill that lowers LDL cholesterol by about 60%, offering a needle-free alternative to injections and statins for those who can’t tolerate them; the drug’s development builds on PCSK9 genetics, and while LDL reductions look promising, hard outcomes like deaths will take years to prove, and cost and access—alongside the potential of gene editing and other therapies—will shape how broadly it helps curb heart disease.
The FDA approved Lipfendra, Merck's oral cholesterol-lowering drug that blocks the PCSK9 protein, offering a non-injectable option to reduce LDL cholesterol by up to about 60% after 24 weeks in trials. It targets hypercholesterolemia (including familial forms) for patients often already on statins, expanding treatment beyond injectable PCSK9 inhibitors. Lipfendra is priced at $10.50 per day (about $315 for a 30‑day supply), with Merck signaling lower out‑of‑pocket costs. The approval aligns with evolving guidelines urging aggressive LDL targets to cut heart-disease and stroke risk.
A recent JAMA study suggests that the apolipoprotein B (apoB) test, which counts harmful cholesterol particles, may identify people at risk for heart attack or stroke more accurately than standard LDL measurements; using apoB to guide when to intensify statin therapy could prevent more cardiovascular events, but it should be used as an additive tool alongside the regular lipid panel, especially for those with diabetes, obesity, metabolic syndrome, or high triglycerides.
The portfolio diet combines four LDL-lowering components—plant protein (soy), plant sterols, tree nuts, and soluble fiber—into a daily plan and may reduce LDL cholesterol by up to about 29–30%, in some cases rivaling low-dose statins. Key targets include 35 g/day of plant protein, 2 g/day of plant sterols, 42 g/day of tree nuts, and 18 g/day of soluble fiber, with psyllium husk and fortified foods helping meet goals. While promising, statins have additional benefits beyond LDL reduction, and you should follow a clinician’s advice if prescribed.
Updated ACC/AHA cholesterol guidelines emphasize earlier detection and personalized risk assessment, with more aggressive LDL-C lowering and a new PREVENT risk calculator for 10- and 30-year risk starting at age 30; recommend one-time Lp(a) testing, consider risk enhancers and coronary calcium scoring to tailor therapy, set LDL targets of <100 mg/dL for most, <70 mg/dL for intermediate risk, and <55 mg/dL for high risk, and expand therapies beyond statins (ezetimibe, bempedoic acid, PCSK9 inhibitors); childhood screening for familial hypercholesterolemia is advised, while lifestyle remains foundational.
The ACC/AHA issued major updates to cholesterol guidelines—the first since 2018—emphasizing earlier detection (including possible screening starting at age 9 for those with a family history), more aggressive, personalized statin therapy, and a renewed focus on lifestyle changes; saturated fats are highlighted as the primary dietary driver of blood cholesterol, not dietary cholesterol, and a new validated tool helps clinicians tailor treatment.
A DNA-based treatment using polypurine hairpins to silence PCSK9 lowers LDL cholesterol and boosts LDL receptors. In liver cells HpE9/HpE12 reduced PCSK9 RNA by up to 74% and protein by up to 87%; in transgenic mice a single injection cut PCSK9 by ~50% and cholesterol by ~47% within days, potentially offering a statin-free alternative with fewer side effects.
A Mass General Brigham study finds the PCSK9 inhibitor evolocumab, added to standard therapy, reduces the risk of a first major cardiovascular event by 31% over ~5 years in high‑risk diabetics without diagnosed atherosclerosis, with about a 51% drop in LDL‑C. Safety was similar to placebo, suggesting earlier intensive cholesterol lowering may prevent heart attacks and strokes in patients without established artery disease; results were presented at the ACC and published in JAMA.
The 2026 American dyslipidemia guideline endorses PREVENT-ASCVD risk equations to guide primary prevention therapy and suggests considering lipid-lowering treatment for adults at intermediate risk based on a 10-year PREVENT-ASCVD risk, with additional considerations for borderline risk and for patients with moderate subclinical atherosclerosis, aiming to lower LDL cholesterol.
The 2026 ACC/AHA Guideline on Dyslipidemia consolidates evidence-based recommendations, retires the 2018 cholesterol guideline, and stresses earlier lifestyle measures from childhood along with earlier pharmacotherapy for familial hypercholesterolemia and high LDL-C. It also adopts the PREVENT-ASCVD risk equations to guide lipid-lowering therapy in adults aged 30–79, aiming to improve ASCVD prevention.