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She was a 32-year-old aerobics instructor from a Dallas suburb — healthy, college-educated, with two young children. Nothing out of the ordinary, except one thing. Her cholesterol was astoundingly low. Her low-density lipoprotein, or LDL, the form that promotes heart disease, was 14, a level unheard-of in healthy adults, whose normal level is over 100. The reason: a rare gene mutation she had inherited from both parents. Only one other person, a young, healthy Zimbabwean woman whose LDL cholesterol was 15, has ever been found with the same mutation. The discovery of the mutation and of the two women with...

A mutation that gives people rock-bottom cholesterol levels has led geneticists to what could be the next blockbuster heart drug. When Sharlayne Tracy showed up at the clinical suite in the University of Texas (UT) Southwestern Medical Center in Dallas last January, the bandage wrapped around her left wrist was the only sign of anything medically amiss. The bandage covered a minor injury from a cheerleading practice led by Tracy, a 40-year-old African American who is an aerobics instructor, a mother of two and a college student pursuing a degree in business. “I feel like I'm healthy as a horse,”...

Revised guidelines for heart health are set to move away from target-based approach. Soon after Joseph Francis learned that his levels of ‘bad’ LDL cholesterol sat at twice the norm, he discovered the short­comings of cholesterol-lowering drugs — and of the clinical advice guiding their use. Francis, the director of clinical analysis and reporting at the Veterans Health Administration (VA) in Washington DC, started taking Lipitor (atorvastatin), a cholesterol-lowering statin and the best-selling drug in pharmaceutical history. His LDL plummeted, but still hovered just above a target mandated by clinical guidelines. Adding other medications had no effect, and upping the...

Scientists from the University of Warwick have discovered why a newly found form of cholesterol seems to be 'ultra-bad', leading to increased risk of heart disease. The discovery could lead to new treatments to prevent heart disease particularly in people with type 2 diabetes and the elderly. The research, funded by the British Heart Foundation (BHF), found that 'ultrabad' cholesterol, called MGmin-low-density lipoprotein (LDL), which is more common in people with type 2 diabetes and the elderly, appears to be 'stickier' than normal LDL. This makes it more likely to attach to the walls of arteries. When LDL attaches to...

THE idea that cholesterol plays a key role in heart disease is so tightly woven into modern medical thinking that it is no longer considered open to question. This is the message that emerged all too clearly from the recent news that the drug Vytorin had fared no better in clinical trials than the statin therapy it was meant to supplant. Vytorin is a combination of cholesterol-lowering drugs, one called Zetia and the other a statin called Zocor. Because the two drugs lower LDL cholesterol by different mechanisms, the makers of Vytorin (Merck and Schering-Plough) assumed that their double-barreled therapy...

Vital Signs Drinking decaffeinated coffee can raise the level of L.D.L., the bad cholesterol associated with cardiovascular disease risk, new research suggests. The effect is significant, according to Dr. H. Robert Superko of the Fuqua Heart Center in Atlanta, who led the study. "If an individual has elevated L.D.L. and wants to lower it without drugs," Dr. Superko said, "a combined approach of diet, exercise, weight loss and cessation of decaffeinated coffee - if they drink three to six cups a day - could reduce the L.D.L. 30 percent and help avoid lifelong drug therapy." The study, financed by the...

Federal health officials yesterday sharply reduced the desired levels of harmful cholesterol for Americans who are at moderate to high risk for heart disease. The new recommendations call for treatment with cholesterol-lowering drugs for millions of Americans who had thought their cholesterol levels were fine. Already more than 10 million people take the drugs. But now, more should start, the recommendations say. For people at the highest risk, they suggest that the target level of L.D.L., the type of cholesterol that increases the likelihood of heart disease, should be less than 100. That is 30 points lower than previously recommended....

Lowering cholesterol far below the level that most doctors now consider adequate can substantially reduce patients' risk of having or dying from a heart attack, researchers reported today. The findings, cardiologists say, will greatly change how doctors treat patients with heart disease and will provide the impetus to re-evaluate how low cholesterol levels should be. The study compared high doses of one of the most powerful cholesterol-lowering drugs, Pfizer's Lipitor, to a less potent drug, Pravachol, made by Bristol-Myers Squibb, which conducted the trial. The patients taking Lipitor were significantly less likely to have heart attacks or to require bypass...