Cutting Cholesterol

The National Heart Institute is barely halfway through an ambitious project to evaluate four drugs for possible use in preventing heart attacks by lowering the level of cholesterol in the blood. Last week a preliminary--premature, said some doctors--report raised hope that one of the drugs may already have prevented some attacks.

Dr. Louis R. Krasno told a Senate subcommittee that in research for United Air Lines in San Francisco he had studied 1,400 ground personnel for 31 years. All were men aged 41 to 60; half of them had taken four daily capsules of clofibrate (trade-named Atro-mid-S), while the other half received dummy capsules. So far, there have been 47 new heart attacks, 37 among the 700 men on the placebo, but only ten among those on clofibrate. Of 17 attacks among men who had previously had a heart attack, only three struck men on the drug. There were twelve fatal heart attacks, but only four among men taking clofibrate.

Although these early results seemed impressive, Dr. Krasno conceded that longer-range studies involving many more subjects are needed. The Heart Institute project has so far recruited 4,800 men for testing, and will eventually have 8,400 at 55 clinics across the U.S. The test program involves four drugs: dextrothyroxine (Choloxin), nicotinic acid (niacin) and estrogens (female sex hormones) in addition to clofibrate. Unlike the Krasno study, the

N.H.I, research is "double-blind," meaning that those who are conducting the test let neither doctors nor the randomly selected patients know who is receiving the active drug until the conclusion of the tests.* All four drugs are already known to be effective in cutting down blood levels of cholesterol; the all-important question, still unanswerable, is whether this will protect the arteries, so as to prevent coronary occlusions and premature death, without causing serious side effects.

*The double-blind requirement results in omission of a fifth important and promising drug, cholestyramine or Questran (TIME, Oct. 13). Because this is bulky and must be taken in liquid form, it cannot readily be paired with a placebo.

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