Medicine: Cutting the Cholesterol

Though medical researchers are still not sure how fats in the diet affect artery disease and the risk of heart attacks, practicing physicians are not waiting for final answers. More and more doctors believe that it is wise anyway to reduce the amount of fats and related substances, notably cholesterol, in their patients' bloodstreams. Last week Cincinnati's. William S. Merrell Co. announced that it is start ing general distribution of a cholesterol-cutting chemical just approved (for prescription sale only) by the Food and Drug Administration. The chemical: triparanol, trade-named MER/2^. The makers claim that a single capsule daily will drop the blood cholesterol of 80% of patients to near normal, and presumably safer, levels.

Principal beneficiaries of the treatment, which has been tested on 2,000 patients for as long as two years, will be men in the middle and upper age ranges. Women enjoy natural protection through their sex hormones or estrogens against the worst ravages of atherosclerosis, in which cholesterol and related fatty substances clog the arterial tubes. Triparanol synthesized by Merrell, is such close kin to female sex hormones that it has been whimsically dubbed a "nonestrogenic estrogen."

Men who have had heart attacks and those with angina pectoris—clear signs of coronary atherosclerosis—often have abnormally high levels of blood cholesterol. Some of it may come from the diet, especially butterfat, but researchers attach more importance to that produced within the body itself. The human system is a busy and versatile cholesterol factory, can make the stuff from practically any food, especially saturated fats.

Triparanol, say Merrell researchers, works by blocking a late stage of cholesterol manufacture in the liver. This means that unusually large amounts of a preceding substance, desmosterol, are left sloshing around in the blood. As Boston's noted heart specialist, Dr. Robert W. Wilkins, has pointed out, nobody knows yet what effect this added desmosterol will have on patients. So far, undesirable reactions have been few and mild (nausea and occasional rashes). Whatever triparanol's ultimate effect on patients' health and survival, the drug gives physicians a chance to find some of the answers that laboratory research has not been able to give.