Two interventions—lowering blood lipid levels of LDL (“bad”) cholesterol (LDL-C) and regularly taking aspirin to prevent blood clots—are known to help reduce the risk for heart attacks and strokes. 

Now, a new study by Gaetano Santulli, M.D., Ph.D., and colleagues found that low LDL-C levels can cause unintended risks for certain patients. The researchers examined data from nearly 40,000 patients in Italy over a 15-year period. They found that aspirin-treated patients with LDL-C levels below 70 mg/dL had a significantly higher (18%) likelihood of suffering gastrointestinal, cerebral, urogenital, and other bleeding events compared with patients with higher LDL-C levels. Of note, LDL-C levels below 70 mg/dL are often a treatment goal for patients on lipid-lowering therapy.

The findings challenge the notion that lower LDL-C is always better and indicate the need for an individualized approach to lipid-lowering therapy for patients taking aspirin or other anti-clotting medications. The study was published online on March 5 in Pharmacological Research.

Dr. Santulli is an associate professor of medicine and of molecular pharmacology at Einstein.