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June 7, 2006

High-Dose Statins and the IDEAL Study

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;295(21):2476-2479. doi:10.1001/jama.295.21.2476-a

To the Editor: In the IDEAL study, Dr Pedersen and colleagues1 did not consider that about 95% of the patients receiving either 20 mg/d of simvastatin or 80 mg/d of atorvastatin experienced adverse effects, almost half of which were classified as serious. The results of previous statin trials suggest that only 7% to 8% of participants (and often much fewer) derived significant benefits, mostly with respect to a reduction in risk of nonfatal events.2,3 Since many myocardial infarctions and strokes are not associated with permanent disability or serious sequelae, the high incidence of adverse effects in this study should cause concern. We would appreciate more detailed information about the number and nature of these adverse reactions.