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June 14, 2000

Statins and Risk of Coronary Heart Disease—Reply

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;283(22):2935. doi:10.1001/jama.283.22.2931

In Reply: Dr Clemenson raises the important issue of primary vs secondary prevention. In our meta-analysis, which included 2 primary prevention trials with 13,200 participants and 3 secondary prevention trials with 17,617 participants, statin drug treatment was associated with a 34% proportional risk reduction (P<.001) in major coronary events in the primary prevention trials and a 30% proportional risk reduction (P<.001) in the secondary prevention trials. Because of the homogeneity of proportional risk reduction in primary and secondary prevention trials, results from individual trials were pooled to provide more accurate and precise estimates. Our analysis indicated that the proportional risk reduction of major coronary events associated with statin drug treatment was similar in men (27%) and women (31%) and in participants who were aged 65 years or older (23%) and those who were younger than 65 years (31%). These findings strongly suggest that cholesterol lowering by statins is effective for the primary prevention of coronary disease in both men and women regardless of age.

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