Lower Cholesterol Target Cuts Heart Attack Risk, Trial Finds

A major clinical trial published by the New England Journal of Medicine found that pushing LDL cholesterol below 55 mg/dL reduced three-year cardiovascular events more than the standard target of below 70 mg/dL in patients with established heart disease.

The New England Journal of Medicine has posted results from the Ez-PAVE trial, which tested whether a more aggressive cholesterol-lowering target could reduce the risk of heart attacks and strokes in people who already have atherosclerotic cardiovascular disease (a condition where fatty deposits narrow and harden the arteries). According to the journal, patients whose treatment aimed to bring their LDL — often called “bad” cholesterol — below 55 mg per deciliter fared better over three years than those treated to the less strict target of below 70 mg per deciliter.

The findings matter because LDL targets are central to how cardiologists manage long-term heart disease risk. Current UK guidelines already recommend lower LDL thresholds for high-risk patients, but the Ez-PAVE results suggest pushing further still may offer measurable benefit. The trial does not change NHS guidance on its own — that requires review by bodies such as NICE — but it adds to the body of evidence that tighter cholesterol control saves lives in this patient group.

If you have been diagnosed with cardiovascular disease and have questions about your cholesterol targets or medication, speak to your GP rather than adjusting treatment yourself.

Key information

• Speak to your GP if you have concerns about your cholesterol levels or heart disease management
• Call NHS 111 for non-emergency medical advice
• In an emergency, call 999