The benefits of treating hyperlipidemia to prevent coronary heart disease: estimating changes in life expectancy and morbidity

Article Abstract:

A computer program developed at McGill University, Montreal, may be able to predict how much longer individuals at risk for heart disease will live if they reduce their risk factors. The program uses a model from the Framingham Heart Study that estimates the probability of an individual developing heart disease based on several risk factors. It was used to predict the delay in developing heart disease and the increase in life expectancy of a group of hypothetical men and women between 35 and 65 years old who were being treated for hypercholesterolemia, or elevated blood cholesterol. The program predicted that reducing blood cholesterol from 300 to 200 mg/dL in young, low-risk individuals would increase their life expectancy an average of one to 1.64 years. But in high-risk individuals, such a reduction could delay the development of heart disease by as much as five years and increase their life expectancy as much as three years. The program's predictions agree with data collected in the MRFIT study, the Helsinki Heart Study and the Lipid Research Clinics Trial.

Care and treatment, Software

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Identifying adults at increased risk of coronary disease: how well do the current cholesterol guidelines work?

Article Abstract:

High-density lipoprotein (HDL) cholesterol level guidelines are valid predictors of the risk of death from coronary heart disease. Researchers compared mortality with cholesterol levels and other risk factors in 3,678 men and women aged 35 to 74 who did not have symptoms of heart disease. A total of 77 deaths were recorded over a 12-year period. A computer risk model and screening guidelines were used to assess the risk of death. The ratio of total cholesterol to high-density lipoprotein was found to be as good a predictor of increased coronary risk as the current screening guidelines proposed by the National Cholesterol Education Program. Decreasing levels of HDL, and increasing levels of low-density lipoprotein cholesterol, total cholesterol, and triglycerides were associated with a higher risk of coronary heart disease. HDL levels were the most valid single lipid predictor of coronary heart disease risk. The importance of HDL previously has not been realized. Other risk factors are male sex, cigarette smoking, diabetes, high blood pressure, and overweight.

Measurement, Risk factors, Blood cholesterol, Lipoproteins

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The cost-effectiveness of HMG-CoA reductase inhibitors to prevent coronary heart disease: estimating the benefits of increasing HDL-C

Article Abstract:

Three-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors may be cost-effective in preventing coronary heart disease (CHD) in specific groups of adults with high cholesterol. Researchers used a computer model to calculate the cost-effectiveness of 20 milligrams per day of the HMG-CoA reductase inhibitor lovastatin in preventing CHD in people with high cholesterol. Lovastatin therapy was most cost-effective in three groups of people: men aged 30 to 70 at high risk for CHD, middle aged men at low risk for CHD, and women aged 50 to 70 at high risk for CHD. In these groups, the costs of lovastatin treatment per year of life saved ranged from $20,882 to $50,079 in Canadian dollars. In the other groups of patients, the costs of lovastatin therapy ranged from $51,293 to $155,891 in Canadian dollars per year of life saved.

Economic aspects, Prevention, Drug therapy, Enzyme inhibitors, Lovastatin

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