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Are we aggressive enough in lowering cholesterol?

  • David D Waters
    Correspondence
    Address for reprints: David D. Waters, MD, Cardiology Division, Room 5G1, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, California 94110
    Affiliations
    Cardiology Division, Department of Medicine, San Francisco General Hospital, San Francisco, California, USA

    Department of Medicine, University of California, San Francisco, California, USA
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      Abstract

      To date, 5 major randomized, placebo-controlled statin trials—the Scandinavian Simvastatin Survival Study, West of Scotland Coronary Prevention Study, Cholesterol and Recurrent Events trial, Long-term Intervention with Pravastatin in Ischaemic Disease, and Air Force/Texas Coronary Atherosclerosis Prevention Study—have convincingly shown that total mortality and major coronary events can be significantly reduced by lowering levels of low-density lipoprotein cholesterol (LDL-C) with statin therapy. These results were achieved in a broad range of patients including those with and without a history of coronary artery disease and with elevated or average LDL-C levels. The results also support the large body of epidemiologic evidence demonstrating that the lower the cholesterol level, the lower the cardiovascular risk. Evidence now substantially supports the urgency of physicians to aggressively target the lowering of LDL-C levels for the primary and secondary prevention of coronary disease.
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