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December 1, 1989

Putting Cholesterol Control on a Diet

Author Affiliations

Brown University The Miriam Hospital Providence, RI

Brown University The Miriam Hospital Providence, RI

JAMA. 1989;262(21):2998. doi:10.1001/jama.1989.03430210036018

To the Editor.—  Opposition to the current National Cholesterol Education Program guidelines borders on the unpatriotic. Nevertheless, I read the July 7 issue of JAMA on July 4 and would like to exercise my independence by offering the following expansion of Table 4 from the lead article by Wilson et al.1I added the percentage of patients asked to return at 1 year and immediately who are not helped (in 6 years) because they were among those not destined to suffer coronary heart disease. The Table shows that for the majority of patients subjected to anxiety, dietary restriction, and possibly lipid-lowering drugs, there is no 6-year benefit. Only in the older two groups does the effort seem worthwhile. This ignores the possibility of physical and psychological harm to those who are treated and the probability that intervention in those destined to suffer a coronary heart disease event may