Cholesterol Reduction and Stroke
Authors: George Davey Smith
Journal: Annals of Internal Medicine (1994)

Letters1 January 1994Cholesterol Reduction and StrokeGeorge Davey Smith, MD, Matthias Egger, MD, and Trevor A. Sheldon, MScGeorge Davey Smith, MDUniversity of Glasgow; Glasgow G12 8RZ; ScotlandUniversity of Berne; CH-3012 Berne; SwitzerlandUniversity of York; York; United KingdomSearch for more papers by this author, Matthias Egger, MDUniversity of Glasgow; Glasgow G12 8RZ; ScotlandUniversity of Berne; CH-3012 Berne; SwitzerlandUniversity of York; York; United KingdomSearch for more papers by this author, and Trevor A. Sheldon, MScUniversity of Glasgow; Glasgow G12 8RZ; ScotlandUniversity of Berne; CH-3012 Berne; SwitzerlandUniversity of York; York; United KingdomSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-1-199401010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Atkins and colleagues' meta-analysis [1] of stroke in randomized, controlled trials of cholesterol reduction shows the problems inherent in this technique. The first is publication bias; unpublished studies may have systematically different results from published ones. The second is selection bias; required data may be unavailable in published sources. For example, stroke mortality data were only reported for a few single-factor cholesterol intervention studies, and only such trials were included. Researchers doing meta-analyses should obtain the most complete data possible. We collected these data while doing a recent meta-analysis of cholesterol lowering and mortality [2]. For all ...References1. Atkins D, Psaty BM, Koepsell TD, Longstreth Jr WT, Larson EB. Cholesterol reduction and the risk for stroke in men. A meta-analysis of randomized, controlled trials. Ann Intern Med. 1993; 119:136-45. Google Scholar2. Davey Smith G, Song F, Sheldon TA. Cholesterol lowering and mortality: the importance of considering initial level of risk. Br Med J. 1993; 306:1367-73. Google Scholar3. Veterans Administration Cooperative Study Group. The treatment of cerebrovascular disease with clofibrate. Stroke. 1973; 4:684-93. Google Scholar4. Committee of Principal Investigators. A co-operative trial in the primary prevention of ischaemic heart disease using clofibrate. Br Heart J. 1978; 40:1069-118. Google Scholar5. Heady JA, Morris JN, Oliver MF. WHO clofibrate/cholesterol trial: clarification (Letter). Lancet. 1992; 340:1405-6. Google Scholar Author, Article, and Disclosure InformationAuthors: George Davey Smith, MD; Matthias Egger, MD; Trevor A. Sheldon, MScAffiliations: University of Glasgow; Glasgow G12 8RZ; ScotlandUniversity of Berne; CH-3012 Berne; SwitzerlandUniversity of York; York; United Kingdom PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1994Volume 120, Issue 1Page: 88-89KeywordsCholesterolConfidence intervalsGlobal healthIntent to treat analysisMortalityNiacinOdds ratioResearch designStrokeSurvival analysis ePublished: 15 August 2000 Issue Published: 1 January 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...