This issue of The Journal contains an article by Blanken-horn et al1 that deserves, dear reader, your careful scrutiny. Aggressive diet and drug therapy appear to have led to sustained large reductions in blood cholesterol levels and, more importantly, to a reduced rate of development and progression of coronary artery and vein bypass graft lesions in patients who have undergone aortocoronary bypass graft surgery. The study is a substantial addition to the already extensive body of literature that links blood cholesterol level to atherosclerotic vascular disease in general and to coronary artery disease in particular.2-6 The implications of this study for the several million individuals who have undergone coronary bypass surgery are substantial.
Coronary artery disease remains a major public health problem in the United States, despite an encouraging 37% reduction in age-adjusted mortality rates noted during the last two decades.7 In 1985, an estimated 540 000
Passamani ER. Cholesterol Reduction in Coronary Artery Bypass Patients. JAMA. 1987;257(23):3271-3272. doi:10.1001/jama.1987.03390230107036