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LDL control cuts CVD in chronic kidney disease

Lowering LDL cholesterol with simvastatin plus ezetimibe safely reduces the risk of major atherosclerotic events in nearly all patients with chronic kidney disease, a major new UK-led trial has shown.

GPs were encouraged to consider prescribing lipid-lowering therapy to patients with advanced CKD on the strength of the study's results – published in the Lancet last week – which are the first to show that cholesterol lowering produces a significant reduction in primary vascular disease in renal patients.

Researchers randomised 4,650 patients with CKD but no known history of myocardial infarction to receive simvastatin 20mg plus ezetimibe 10mg daily, and 4,620 patients to placebo.

Allocation to simvastatin plus ezetimibe yielded an average LDL cholesterol fall of 0.85mmol/l relative to placebo during a median follow-up of 4.9 years and produced a 17% proportional reduction in major atherosclerotic events and a significant 15% relative reduction in non-haemorrhagic stroke.



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