Lack of Evidence for Recommended Low-Density Lipoprotein Cholesterol Treatment Targets
Authors: Uffe Ravnskov
Journal: Annals of Internal Medicine (2007)

Letters17 April 2007Lack of Evidence for Recommended Low-Density Lipoprotein Cholesterol Treatment TargetsUffe Ravnskov, MD, PhDUffe Ravnskov, MD, PhDFrom Lund, Sweden.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-8-200704170-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: Hayward and colleagues (1) rightly point out the extreme weakness of ecological comparisons among statin trials. Their concern is justified by the lack of dose response between the degree of cholesterol lowering and the clinical (2, 3) or angiographic (4) outcome found in the trials where dose response was calculated by using individual data. The fact that patients with the worst prerandomization LDL cholesterol level response received the same benefit as that of patients with the best response strongly indicates that most if not all benefits from the statins are mediated through their pleiotropic effects and not ...References1. Hayward RA, Hofer TP, Vijan S. Narrative review: lack of evidence for recommended low-density lipoprotein treatment targets: a solvable problem. Ann Intern Med. 2006;145:520-30. [PMID: 17015870] LinkGoogle Scholar2. Sacks FM, Moyé LA, Davis BR, Cole TG, Rouleau JL, Nash DT, et al. Relationship between plasma LDL concentrations during treatment with pravastatin and recurrent coronary events in the Cholesterol and Recurrent Events trial. Circulation. 1998;97:1446-52. [PMID: 9576424] CrossrefMedlineGoogle Scholar3. Schwartz GG, Olsson AG, Ezekowitz MD, Ganz P, Oliver MF, Waters D, et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized, controlled trial. JAMA. 2001;285:1711-8. [PMID: 11277825] CrossrefMedlineGoogle Scholar4. Ravnskov U. Is atherosclerosis caused by high cholesterol? QJM. 2002;95:397-403. [PMID: 12037248] CrossrefMedlineGoogle Scholar5. Ravnskov U. High cholesterol may protect against infections and atherosclerosis. QJM. 2003;96:927-34. [PMID: 14631060] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Uffe Ravnskov, MD, PhDAffiliations: From Lund, Sweden.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNarrative Review: Lack of Evidence for Recommended Low-Density Lipoprotein Treatment Targets: A Solvable Problem Rodney A. Hayward , Timothy P. Hofer , and Sandeep Vijan Lack of Evidence for Recommended Low-Density Lipoprotein Cholesterol Treatment Targets Rodney A. Hayward Lack of Evidence for Recommended Low-Density Lipoprotein Cholesterol Treatment Targets Geoffrey A. Modest Metrics Cited byProportion of High-Risk/Very High-Risk Patients in Europe with Low-Density Lipoprotein Cholesterol at Target According to European Guidelines: A Systematic ReviewExcessive intimal hyperplasia in human coronary arteries before intimal lipid depositions is the initiation of coronary atherosclerosis and constitutes a therapeutic targetResponse to Ravnskov et al. on saturated fat and CHD 17 April 2007Volume 146, Issue 8 Page: 614 Keywords Cholesterol Clinical trials Cohort studies Conflicts of interest Drugs Endotoxins Hypercholesterolemia Low density lipoprotein Medical risk factors Statins ePublished: 17 April 2007 Issue Published: 17 April 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...