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June 23, 1989

Current Therapy for Hypercholesterolemia

JAMA. 1989;261(24):3582-3587. doi:10.1001/jama.1989.03420240096034

THE EVIDENCE is now in that lowering cholesterol levels reduces the risk of coronary heart disease (CHD). A century of animal data as well as morphological, genetic, and metabolic studies in man point to a strong association between serum cholesterol levels and coronary artery disease. Prospective epidemiologic studies show a graded relationship between serum cholesterol and coronary risk extending to cholesterol levels below 4.14 mmol/L (<160 mg/dL), ie, well into the desirable range for serum cholesterol.1 Clinical trials performed in man provide the final validation of the cholesterol-atherogenesis connection. In the Lipid Research Clinics Coronary Primary Prevention Trial, over a 7-year period a 12.5% decrease in low-density lipoprotein (LDL) cholesterol levels was associated with a 19% decrease in the incidence of myocardial infarction and CHD death.2,3 In addition, treatment was associated with a significant reduction in the development of angina, a positive exercise test, and the need for