Another approach to the cholesterol problem was to target only those with high blood cholesterol levels, and to treat them with drugs. Drugs to lower blood cholesterol levels were studied first in the 1970s, but they have had a troubled history since then.
WHO and Clofibrate.
The first study, the WHO Cooperative Trial of the cholesterol-lowering drug clofibrate, followed 15,745 healthy men in Edinburgh, Budapest, and Prague. Treatment was based on their cholesterol levels. Those in the upper third for blood cholesterol levels were allocated at random either to the clofibrate, or to a placebo. Those in the lower third for cholesterol levels were also given a placebo—they were the baseline control. The study was double blind, so that researchers and patients did not know what they were taking or in what group they were.
The results for heart attacks were mildly encouraging, as the clofibrate group had fewer nonfatal heart attacks than the high cholesterol group given a placebo. However, the clofibrate group had the highest overall number of deaths—a result that stopped the use of the drug in its tracks! This was despite its lowering the cholesterol levels by an average of 9 percent.
The excess of deaths of people taking clofibrate were not due to a single disease or discernible cause. The greatest benefit of cholesterol-lowering was in younger men with moderately raised cholesterol levels, but this was overshadowed by the unexpected extra deaths. The use of cholesterol-lowering drugs in anyone other than people with extremely high cholesterol levels has never fully recovered from that trial result.
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