There is a growing body of evidence that suggests that lower LDL cholesterol levels may be beneficial in reducing the risk of heart disease, and that targets below 70 mg/dL may be appropriate for certain individuals.
A number of large clinical trials have demonstrated that intensive LDL cholesterol lowering with statins or other cholesterol-lowering medications can lead to significant reductions in the risk of cardiovascular events, such as heart attacks and strokes. The IMPROVE-IT trial, for example, found that in patients with acute coronary syndrome, lowering LDL cholesterol to an average of 55 mg/dL with the addition of ezetimibe to simvastatin therapy reduced the risk of major cardiovascular events by 6% compared to simvastatin therapy alone.
Additionally, a meta-analysis of 14 randomized controlled trials involving 34,000 participants found that for every 1.0 mmol/L (38.7 mg/dL) reduction in LDL cholesterol, there was a corresponding 22% reduction in the risk of cardiovascular events.
Furthermore, some observational studies and genetic studies have also suggested that even lower LDL cholesterol levels may be associated with a reduced risk of heart disease. For example, a study of more than 126,000 individuals found that those with LDL cholesterol levels below 70 mg/dL had a significantly lower risk of heart disease compared to those with LDL cholesterol levels above 70 mg/dL.
However, it’s also important to note that while lower LDL cholesterol levels may be beneficial, very low cholesterol levels may also be associated with an increased risk of other health problems, such as cancer, and more research is needed to understand the optimal LDL cholesterol target for different individuals and populations.
In summary, there is evidence that lower LDL cholesterol levels, below 70 mg/dL, may be associated with a reduced risk of heart disease, but it’s important to note that this evidence is not conclusive and more research is needed to understand the optimal LDL cholesterol target for different individuals and populations. The decision to lower LDL cholesterol levels below 70 mg/dL should be made on an individual basis, taking into account the patient’s specific risk factors and medical history, as well as the cost-effectiveness and affordability of the medication.