To the Editor.—
The recent publication of the Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT) results1 in The Journal was met with considerable enthusiasm by the news media and the general public. Some misconceptions among these groups warrant a few basic clarifications for our patients.First, the LRC-CPPT cannot be used to support the still unproved notion that diet modification, by itself, has any statistically significant effect in prevention of coronary heart disease (CHD). The authors of the report themselves concede that, although other randomized trials of diet or drug therapy have shown trends toward lower incidence of CHD, "no single one of these studies is convincing." They further state that their own study "was not designed to assess directly whether cholesterol lowering by diet prevents CHD." The LRC-CPPT was a test of cholestyramine resin v placebo; both study groups followed the same diet.Second, the results of
Norenberg DD. Lipid Research Clinics Program. JAMA. 1984;252(18):2545. doi:10.1001/jama.1984.03350180015008
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