Prior to the advent of statins and the 4S study with simvastatin,1 many in the cardiology community viewed lowering cholesterol with drugs as a practice with doubtful value.2 Statin drugs were game changers in the practice of preventive cardiology and in the acceptance of low-density lipoprotein cholesterol (LDL-C) reduction as a surrogate for risk reduction of coronary heart disease. While the earliest statin trials addressed secondary prevention and high-risk individuals, subsequent studies have treated increasingly lower-risk individuals and those with progressively lower baseline LDL-C levels.
Gotto AM. Low-Density Lipoprotein Cholesterol and Cardiovascular Risk Reduction: How Low Is Low Enough Without Causing Harm? JAMA Cardiol. 2018;3(9):802–803. doi:10.1001/jamacardio.2018.2273
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