How healthy lifestyles and cholesterol medication improve heart health

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Combining healthy lifestyle habits, such as exercising, avoiding smoking, and eating healthy, can lead to positive changes in an individual’s cholesterol profile that are different but complementary to the effects of cholesterol-lowering medications, according to research led by Harvard T.H. Chan School of Public Health.

“Until now, no studies have compared the lipid-lowering effects of cholesterol-lowering medications and healthy lifestyle interventions side by side,” lead author Jiahui Si, postdoctoral research fellow in the Department of Epidemiology, said in a Feb. 16 eLife article.

To understand how lifestyle interventions affect cholesterol, the researchers first measured 61 different lipid markers in nearly 5,000 blood samples from the China Kadoorie Biobank. They then compared lipid markers in the blood of participants who adhered to multiple healthy lifestyle habits with the lipid markers in the blood of participants with less healthy habits. In total, they found 50 lipid markers that were associated with healthy lifestyles.

The team then analyzed data on a subset of individuals who went on to develop heart disease and 1,513 healthy individuals with an eye toward understanding the different impacts cholesterol-lowering medications had when compared with lifestyle interventions.

“Using a genetic scoring technique, we could compare the effect of cholesterol-lowering drugs with that of lifestyle side by side in the study participants,” said co-senior author Liming Liang, associate professor of statistical genetics. “Our analysis confirmed that cholesterol-lowering drugs would have the expected effect in lowering LDL cholesterol, but this is much weaker compared to the effect of healthy behaviors on [very-low-density lipoprotein cholesterol], which also increases the risk of heart disease.”

The study concluded that taking cholesterol-lowering medications and engaging in multiple healthy lifestyles would likely help provide the greatest heart-protecting benefits.