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Letters
July 7, 2004

Aggressive Lipid-Lowering Therapy and Regression of Coronary Atheroma

JAMA. 2004;292(1):38. doi:10.1001/jama.292.1.38-b

To the Editor: Dr Nissen and colleagues1 argued that either total cholesterol or LDL cholesterol should be lowered as much as possible to prevent coronary heart disease. I disagree with this conclusion for several reasons.

First, the study was limited to patients with significant coronary heart disease. Second, pravastatin and atorvastatin have different effects on other relevant factors.2 Third, a comparison was made only between moderate and extensive cholesterol lowering. Fourth, no dose-response relationship was noted for end points such as myocardial infarction or coronary mortality.

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