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MICHELE NORRIS, host:

For some time now, scientists and physicians have believed that one key to heart health is raising levels of so-called good cholesterol in the blood, but there's word now they may be wrong.

Yesterday, the National Institutes of Health called an early halt to a big study. It was looking at a drug called Niaspan, and the study found that while the drug did raise good cholesterol levels, it did not lower the rate of heart attacks, and it also may have slightly raised the risk of stroke.

With us now to explain all this is NPR's Scott Hensley, who edits our health blog called "Shots."

Good to have you here, Scott.

SCOTT HENSLEY: Hi.

NORRIS: First of all, tell us what the theory behind the study was.

HENSLEY: It has been known for decades that people with higher HDL, the good cholesterol, all other things being equal, have a lower risk of heart attacks; it was first seen in people in Japan who had a genetically higher HDL. And this study was one that looked at: Could you get the same sort of effect by raising the HDL with a drug? And it was expected that it would show that, and it didn't.

NORRIS: And why didn't it happen?

HENSLEY: They're still trying to sort that out because it in fact contradicted the hypothesis behind this drug and other drugs like it that are in development, that if you improve the good cholesterol in someone's blood, which helps get the fat out of places that it shouldn't be and out of the body, that it could help people's health.

There was no change in the heart attack risk for people in the study.

NORRIS: Now the drug that we're talking about has been on the market for quite some time, and there are a good number of people taking this drug. What are they supposed to do now that its effects are called into question?

HENSLEY: The FDA got a look at these preliminary data and issued a statement yesterday saying we're not changing the label for the drug, we're not going to change the instructions. People should not stop taking it because of this report.

If you're concerned about it, talk with your doctors, but right now, the data are fairly fresh. They're going to look at them some more, but there's no reason to change practice now.

NORRIS: Who conducted this study and why?

HENSLEY: This study was put together by the National Institutes of Health. The idea was to look at people who had really good control of LDL, that's the bad cholesterol, that's what you take Lipitor for, for instance.

And so all the patients in this study had really well-controlled LDL, but they still had risks for heart disease because they either had low good cholesterol or high levels of something called triglycerides, another fat that's in the blood.

And the expectation was that by adding this drug that raises the HDL to the combination for the people, it would help them, and it did not.

NORRIS: In looking at the reaction to this today, it appears that this study is causing an overall re-thinking of how to prevent heart attacks. Is that an accurate reading of this?

HENSLEY: I think so because the drug industry and doctors have done such a good job at hammering into us lower your bad cholesterol and improve your chances of avoiding a heart attack or a repeat heart attack or stroke, something like that.

They're looking for the next frontier: How can we lower the risk even more? And HDL was thought to be the logical way to do that.

NORRIS: Any early indication about how the makers of Niaspan will respond to this? And what does this mean for other drugs that are in the pipeline that are similar to this?

HENSLEY: Well, Abbott, the maker of Niaspan, is standing behind the drug, and the FDA, as I mentioned, isn't telling anybody to change their practices in prescribing that drug or patients using it.

I think it does raise the bar, though, for drugs that are in development to raise the good cholesterol. Merck is probably the furthest along with a drug that has shown, in studies so far, a very potent HDL-raising effect.

But I think what this study will emphasize is that just changing a number of the kind of fat that's in someone's blood is not really going to be enough. Makers of new drugs to raise HDL will have to show beyond any doubt that the drugs actually help patients.

NORRIS: Scott Hensley edits our health blog. It's called "Shots." Scott, thank you very much for coming in.

HENSLEY: My pleasure.

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