MATTERS OF THE HEART

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It's not only people with significantly elevated blood fats who could benefit from treatment. New research suggests that even those with healthy blood might want to take aggressive steps to ensure that it stays that way.

In a sweeping study, more than 6,600 people with average total cholesterol of 220--just above the optimal 200--were placed on a cholesterol-lowering regimen of diet and exercise. Additionally, half took daily doses of the cholesterol drug pravastatin, while the other half took a placebo. After five years, the group taking the real drug was 36% less likely to have suffered a first heart attack and 33% less likely to have needed coronary bypass or angioplasty. What's more, their bad LDLs had fallen 25% while their good HDLs had risen 6%.

The results, though dramatic, have met with some skepticism. The study was funded by Merck & Co., which sells pravastatin under the name Mevacor. Regular Mevacor treatments can cost $1,200 a year, and with 8 million people in the U.S. having slightly elevated cholesterol, Merck could have a huge new market. For now, however, doctors are impressed, concluding that what's good for Merck could also be good for patients.

SEX UNDER PRESSURE

Tell most people that their health will suffer if they don't get their blood pressure down, and they respond with a shrug. But tell them their sex life will suffer? That gets their attention. In some men, blood-pressure drugs may lead to difficulty achieving erection and ejaculation, but few hypertensive women complain about sexual problems. According to a study by Bassett Healthcare in Cooperstown, N.Y., however, women with hypertension had a harder time achieving adequate vaginal lubrication and orgasm than women with normal blood pressure. Curiously, this was the case regardless of whether the hypertensive women took medication or not.

How blood pressure depresses sexual function is unclear; why men and women react differently to medication is murkier still. The only thing certain from the study is that with hypertension a leading cause of heart attack and stroke, the first priority is still to get the pressure down.

--By Jeffrey Kluger and Michael D. Lemonick