Sorry, It's True

Cholesterol really is a killer

No whole milk. No butter. No fatty meats. Fewer eggs. That has been the gospel of the healthy heart for nearly a quarter-century, and millions have heeded its teachings. Yet each time a believer resolutely pushed away his plate, there was the niggling doubt, or at least the hope, that perhaps the skeptics were right: there was only circumstantial evidence that abstaining from cholesterol-rich food actually protected the heart. No longer. The National Heart, Lung and Blood Institute last week released the findings of a $150 million study tracking the incidence of heart disease in 3,806 men over a period of seven to ten years.

Concluded the director of the project, Dr. Basil Rifkind of the NHLBI: "It is now indisputable that lowering cholesterol with diet and drugs can actually cut the risk of developing heart disease and having a heart attack."

The men in the study, which was conducted at twelve medical centers across the U.S., were between the ages of 35 and 59. None had overt signs of heart disease when they were recruited, but all had abnormally high cholesterol levels of 265 mg per deciliter of blood and above. All the participants were put on a low-cholesterol diet limiting intake of fatty meat, eggs and dairy products. Half were also treated with cholestyramine, a powerful drug that lowers cholesterol; the others received a placebo.

Members of the group on the diet alone reduced their cholesterol levels by around 4%, but levels in the men who also received the drug fell by 18% to 25%, with the sharpest decline coming in the first year of treatment. Analyzing the findings, researchers found that the bigger the drop in cholesterol, the lower the incidence of both fatal and nonfatal heart attacks. When the cholesterol level was reduced by 25%, the risk of heart disease was cut by 50%. The group on medication also had 20% fewer episodes of angina and 21% fewer coronary-bypass operations to restore the free flow of blood to the heart.

Scientists stress that about 25% of U.S. adults, both men and women, need to lower their blood cholesterol. "Know what your level is," advises Rifkind. "If it's above 240, certainly above 250, it should be reduced." His first recommendation is to cut back on cholesterol-rich foods and substitute chicken and fish, for example. "And if that doesn't work, drugs should be considered." Doctors estimate that if Americans followed this prescription wholeheartedly, at least 100,000 of the more than half a million lives claimed by heart disease each year could be saved.