The Legacy of Statins: Advances in Treating High Cholesterol (alumni)
- FHS Communications
Wits researchers involved: Frederick Raal
For the past 30 years, statins have been a game-changer in managing high cholesterol and reducing the risk of heart disease. The Scandinavian Simvastatin Survival Study (4S) was a turning point in proving their effectiveness. Since then, treatments have advanced, but many people worldwide still don’t get the care they need. Wits University researcher Professor Frederick Raal highlights how new treatments can help bridge this gap.
Study Overview
Statins remain the first-line treatment for high cholesterol, including for children with inherited conditions. However, despite being affordable, they are underused. Additional therapies like ezetimibe can further lower bad cholesterol (LDL), and newer treatments are emerging to target other harmful fats in the blood. Techniques like gene-silencing and gene-editing offer promising ways to reduce heart disease risk by blocking proteins such as PCSK9 and ANGPTL3.
Key Findings
Familial hypercholesterolaemia (FH), a genetic form of high cholesterol, affects about 1 in 313 people worldwide. In South Africa, certain groups—including Afrikaners, Jewish, and Indian populations—have much higher rates, with up to 1 in 70 affected due to genetic factors. Professor Raal estimates that around 130,000 people in these communities have FH. In the Black South African population, the prevalence is unknown, but based on global data, an estimated 160,000 people could be affected. This brings the total number of South Africans with FH to between 200,000 and 300,000—yet over 95% remain undiagnosed and untreated.
FH is often missed because high cholesterol has no symptoms. However, Professor Raal stresses that effective and affordable treatments like statins and ezetimibe are available. Without treatment, high cholesterol can lead to heart attacks and strokes as early as ages 40 to 50, devastating families. The study underscores the need for early diagnosis and treatment to prevent these serious health risks.