To the Editor. —
We read with interest the complementary results of the Helsinki Heart Study,1,2 which concluded that both elevating high-density lipoprotein (HDL) cholesterol levels and lowering low-density lipoprotein cholesterol levels are effective in the primary prevention of coronary heart disease (CHD). Nevertheless, we would point out some questions suggested by a careful analysis of the text.There was a significant overall difference in the incidence of CHD between the treatment groups among the Fredrickson types (P<.02). The treatment had a statistically significant effect in type IIB, with 19 cardiac end points (33%) in the gemfibrozil group vs 33 (55%) for the placebo one. Are the results also significant for type IIA, with, respectively, 33 events (28%) vs 44 (35%), and for type IV, with four events (21%) vs seven (34%)? The reduction of CHD with gemfibrozil in type IIA appeared to be smaller compared with type
Emmerich J, Jacotot B. Lipid Level Alterations in the Helsinki Heart Study. JAMA. 1989;261(4):554. doi:10.1001/jama.1989.03420040088011
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