Consensus was reached on final recommendations. Benefits, Harms, and Costs Screening for total blood cholesterol produces many false positive and false negative results which can be reduced by repeat measurement, or by selective lipoprotein analysis. Few or no adverse effects result from individuals assuming falsely that they have high cholesterol levels. 6 RCTs examined the effect of reductions in serum cholesterol on coronary heart disease and 1 RCT examined the safety and efficacy of a lipid-lowering drug. These findings are consistent with those of 2 other meta-analyses.
Adverse effects vary by drug type.
Long-term safety is unknown. No drug trials involving children, young adults, and elderly adults were identified and data on women were limited. No evidence exists from primary prevention trials that dietary modification reduces risk for coronary heart disease. Findings with respect to cardiac, noncardiac and all cause mortality are similar to those described for drug and combined therapy data. Data from 6 community cohort studies involving primarily men aged 30 to 69 years indicated that a possible association exists between risk for coronary heart disease mortality and baseline dietary score, cholesterol and saturated fatty acid intake and a negative association with polyunsaturated fatty acid and fibre intake.