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Individuals with low levels of high-density lipoprotein (HDL; "good") cholesterol and heart disease may benefit from treatment targeted at raising HDL levels. For the 30-month study, 143 retired military personnel with heart disease and low HDL were randomly assigned to a placebo treatment or aggressive HDL-cholesterol-raising therapy with gemfibrozil, niacin, and cholestyramine. The participants also had diet and exercise counseling.
The study's findings showed that the participants in the active treatment group had a 20% decrease in total cholesterol, a 36% rise in HDL cholesterol, a 26% reduction in low-density lipoprotein (LDL; "bad") cholesterol, and a 50% fall in triglycerides, compared with the placebo group. Improvement in the narrowing of the coronary arteries increased by 0.8% in the individuals on active therapy, compared with a decrease of 1.4% in the placebo group. The researchers also determined that significantly more individuals on the placebo therapy than active therapy (26% vs 13%) had a heart attack, stroke, or the need for heart surgery. Reporting their findings in the Annals of Internal Medicine (January 18, 2005), the researchers noted that there is no evidence whether the improvements were due to reductions in LDL or increases in HDL cholesterol.