August 21, 1972

The Coronary Drug Project

Author Affiliations

Fort Collins, Colo

JAMA. 1972;221(8):918. doi:10.1001/jama.1972.03200210062029

To the Editor.—  The directors of the Coronary Drug Project (220:996,1972) should be congratulated for including thyroid in an attempt to delay atherosclerosis. For more than 75 years evidence has been mounting that (1) thyroid deficiency promotes both experimental and clinical atherosclerosis, and (2) desiccated thyroid therapy is safe and effective in delaying vascular accidents in patients with advanced arterial damage.1By the same token, the directors should be censored for selecting dextrothyroxine sodium, a synthetic preparation of variable activity, which has been listed as contraindicated in coronary disease by the Physicians Desk Reference. Undoubtedly, they were misled by statements that this analogue has less metabolic activity than the natural hormone. Per unit of weight, this is true, but effective dosages of each compound reveal that desiccated thyroid or levothyroxine sodium is superior to dextrothyroxine for the reduction of serum lipids. Best and Duncan2 found that in the