Cholesterol Lowering in Older Patients
Authors: Kenneth S. Bannerman, MD
Journal: Annals of Internal Medicine (1999)

Letters20 July 1999Cholesterol Lowering in Older PatientsKenneth S. Bannerman, MDKenneth S. Bannerman, MDMountainside Hospital; Montclair, NJ 07042 (Bannerman)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-2-199907200-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Lewis and colleagues' article on the effect of pravastatin on cardiovascular events in the elderly (1) is incomplete. It does not address the issue of morbidity other than cardiovascular illness or the issue of total mortality. One cannot assume that because a drug reduces cardiovascular events that a corresponding decrease in total mortality will also occur. Indeed, a review of the major studies of cholesterol-lowering drugs shows that there is often a dissociation between cardiovascular event reduction and total mortality. For example, in the Scandinavian Simvastatin Survival Study (4S), an impressive 35% relative risk reduction in cardiovascular ...References1. Lewis JL, Moye LA, Sacks FM, Johnstone DE, Timmis G, Mitchell J, et al . Effect of pravastatin on cardiovascular events in older patients with myocardial infarction and cholesterol levels in the average range. Results of the Cholesterol and Recurrent Events (CARE) trial. Ann Intern Med. 1998;129:681-9. LinkGoogle Scholar2. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Scandinavian Simvastatin Survival Study Group. Lancet. 1994; 344:1383-9. Google Scholar3. Frick MH, Elo O, Haapa K, Heinonen OP, Heinsalmi P, Helo P, et al . Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors and incidence of coronary heart disease. N Engl J Med. 1987;317:1237-45. CrossrefMedlineGoogle Scholar4. Lipid Research Clinics Program: The Lipid Research Clinics coronary primary prevention trial results, I. Reduction in incidence of coronary heart disease. JAMA. 1984; 251:351-64. Google Scholar5. Sacks FM, Pfeffer MA, Moye LA, Rouleau JL, Rutherford JD, Cole TG, et al . The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial Investigators. N Engl J Med. 1996;335:1001-9. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Kenneth S. Bannerman, MDAffiliations: Mountainside Hospital; Montclair, NJ 07042 (Bannerman) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Pravastatin on Cardiovascular Events in Older Patients with Myocardial Infarction and Cholesterol Levels in the Average Range: Results of the Cholesterol and Recurrent Events (CARE) Trial Sandra J. Lewis , Lemuel A. Moye , Frank M. Sacks , David E. Johnstone , Gerald Timmis , Jayne Mitchell , Marian Limacher , Sherron Kell , Stephen P. Glasser , Jane Grant , Barry R. Davis , Marc A. Pfeffer , and Eugene Braunwald Cholesterol Lowering in Older Patients Sandra J. Lewis , Frank Sacks , and Eugene Braunwald Metrics Cited byTratamiento hipolipemiante en ancianos 20 July 1999Volume 131, Issue 2Page: 155KeywordsCholesterolCohort studiesDeath ratesDrugsElderlyLongitudinal studiesMorbidityMortalityMyocardial infarctionRelative risk ePublished: 15 August 2000 Issue Published: 20 July 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...