More than 42 million Americans suffer from high cholesterol, and 63 million more have borderline high cholesterol. Over time, high levels of LDL cholesterol, often called "bad cholesterol," build up along the walls of arteries and blood vessels, a process called atherosclerosis, which can lead to a high risk of heart disease, stroke and heart attack.
For some patients with high cholesterol, physicians routinely prescribe the combination of two cholesterol-lowering medications - statin therapy plus ezetimibe. A new study by University of Virginia Health System researchers, however, adds to mounting evidence that ezetimibe may not halt significant artery wall thickening, or atherosclerosis, in some patients. Despite the medication's proven effectiveness in lowering LDL cholesterol, UVA researchers found a notable progression of atherosclerosis in patients who added ezetimibe to their pre-existing cholesterol-lowering statin medication therapy.
The UVA study, now published online in the journal Atherosclerosis, follows two major clinical studies in 2008 and 2009 that also raised doubts about the benefits of ezetimibe in patients suffering from high LDL cholesterol levels, atherosclerosis and other heart-related problems.
"Patients in our study who had ezetimibe added to pre-existing statin therapy experienced on average a 22 percent decrease in their LDL cholesterol levels; however, we found that in these patients, atherosclerosis progressed at a rate of four percent per year over the two-year study period. That's a troubling rate of progression that occurred, despite the fall in cholesterol," says lead author Christopher M. Kramer, MD, professor of radiology and medicine in the UVA School of Medicine and director of the UVA Cardiovascular Imaging Center.
Kramer's study used magnetic resonance imaging (MRI) to measure plaque buildup in the arteries of patients with peripheral arterial disease (PAD), who were treated with cholesterol-lowering medication for the two-year study period. PAD is a circulatory problem in which narrowed arteries reduce blood flow to limbs, most commonly to the legs.