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January 12, 1994

Target Levels for Low-Density Lipoprotein in Patients With Coronary Heart Disease-Reply

Author Affiliations

University of Texas Southwestern Medical Center at Dallas

JAMA. 1994;271(2):101-102. doi:10.1001/jama.1994.03510260025012

In Reply.  —Dr Rubins takes the summary of the Adult Treatment Panel II report to task for being inadequately documented. The full report, which draws on a very large body of evidence in arriving at its recommendations and contains 640 references, was too lengthy to be published in JAMA but will be published elsewhere.1 The summary could not have reflected the extensive documentation of the full report.Dr Rubins questions the target of a LDL cholesterol level of 100 mg/dL (2.6 mmol/L) or lower for patients with CHD. A lower target for LDL cholesterol was set for such patients because of the very high risk for recurrence of CHD events and because clinical trial evidence shows that cholesterol lowering significantly reduces recurrent CHD. More aggressive therapy for LDL lowering in secondary prevention than in primary prevention thus seems reasonable. The target of 100 mg/dL (2.6 mmol/L) or lower is

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