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August 19, 1998

Disruption and Meaning

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(7):603-604. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-7-jbk0819-n

To the Editor.—In 1988, the European Atherosclerosis Society recommended a therapeutic goal for cholesterol of 5.2 mmol/L (200 mg/dL) and for low-density lipoprotein cholesterol of 3.5 mmol/L (135 mg/dL) in patients with coronary heart disease.1 These therapeutic goals preferably should be reached by dietary measures, but if hypercholesterolemia persists, drug therapy should be initiated. We wondered whether these recommendations, widely distributed in European countries, are accepted in clinical practice and have been influenced by the publication of the results of several secondary intervention studies with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors from 1990 to 1994 and new, more rigorous guidelines.2,3