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The belief by Dr Stare that a high level of blood cholesterol is of minor importance as a risk factor in the development of coronary heart disease is an opinion that is not shared by the majority of experts in this subject area. A total blood cholesterol level of 6.21 mmol/L more than doubles the risk of death due to coronary heart disease compared with a level of 5.17 mmol/L; a level of 7.76 mmol/L quadruples the risk.1,2 There also is substantial evidence that lowering total and low-density lipoprotein cholesterol levels independently will reduce the incidence of coronary heart disease significantly.3-5Dr Stare correctly notes that dietary cholesterol plays a lesser role in the development of hypercholesterolemia than does the excessive intake of saturated fat and that smoking, obesity, diabetes, and a sedentary life-style also are significant risk factors for coronary heart disease. Had he spoken
Ulene A. The AMA's Campaign Against Cholesterol-Reply. JAMA. 1989;261(22):3241. doi:10.1001/jama.1989.03420220054012
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