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Maximum benefit seen with tightest control of risk factors, researchers report

MONDAY, March 23 (HealthDay News) -- The tightest control of the major risk factors for heart disease seems to provide the greatest protection against cardiovascular trouble, a new study shows.

And so the current guidelines for risk factors such as blood pressure and LDL cholesterol might need to be tightened even further, said Dr. Stephen J. Nicholls, an assistant professor of molecular medicine at the Cleveland Clinic, and author of the report, which appears in the March 31 issue of the Journal of the American College of Cardiology.

"It is clear that each benefit we have in terms of lowering LDL cholesterol and blood pressure is going to be important, and the lower you get those measurements, the better," Nicholls said.

Nicholls and his colleagues looked at data on the arteries of 3,437 men enrolled in seven different trials at the Cleveland Clinic. The arteries were examined by ultrasound probes that provided information on the volume of the fatty deposits in the linings of the blood vessels -- deposits that can grow until they block blood flow, causing a heart attack or stroke.

The least amount of growth was seen in those men who had the lowest levels of LDL cholesterol, the "bad" kind that contributes to the fatty deposits, and the lowest levels of blood pressure.

"The rationale for the current analysis was the belief that you should get lower LDL cholesterol and lower blood pressure, and that the benefit is greatest in getting both low," Nicholls said. "And, in fact, the patients who had the best results in terms of growth of the deposits were those with the lowest LDL and lowest blood pressure."

Specifically, the least growth was seen in men with blood cholesterol readings under 70 milligrams per deciliter and systolic blood pressure (the higher of the 120/80 reading) under 120, he said.