Lowest Blood Pressure, Cholesterol Level...( The guideline for blood pressure says...),Health

The guideline for blood pressure says that men at risk can have systolic readings as high as 140 (between 120 and 140 is called "prehypertension"). With blood cholesterol, the current recommendation is for an LDL level of 100 for men at high risk of heart disease, with "consideration" being given to lowering it to 70.

"If you are at high risk, LDL should be below 70," he said. "For blood pressure, you get the greatest benefit if it is below 120."

An accompanying editorial by Drs. Jonathan Tobis and Alice Perlowski of the University of California, Los Angeles, said the results did not necessarily indicate that tighter control of cholesterol and blood pressure would be beneficial.

"You need clinical endpoints to know," said Tobis, director of interventional cardiology research at the UCLA's David Geffen School of Medicine. "They have positive effects on total plaque volume, but the question is whether that corresponds to clinical events such as myocardial infarction [heart attack] and stroke. I suspect that they do, but we haven't proven that yet, and these trials don't prove it."

The composition of a fatty deposit might be as important as its size, Tobis said. Some plaques might be less stable than other, thus prone to rupture and block a blood vessel, he said. "One of the studies included in the report showed that aggressive lowering of LDL reduced the size of the deposits, but we don't know clinically if that makes a difference or not," Tobis said. "Lowering LDL enough might stabilize a plaque so that you get an adequate result."

"The true determination of the impact of our therapy depends on clinical and mortality endpoints, which can only be obtained from large-scale randomized clinical trials," the editorial noted.

Nicholls said he agreed with that assessment. While the study indicates that lowering existing guideline levels for LDL cholesterol and high blood pressure could reduce risk considerably
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