Management of Dyslipidemia for Cardiovascular Disease Risk Reduction
Authors: John R. Downs, Patrick G. O'Malley
Journal: Annals of Internal Medicine (2016)

Letters5 April 2016Management of Dyslipidemia for Cardiovascular Disease Risk ReductionJohn R. Downs, MD and Patrick G. O'Malley, MD, MPHJohn R. Downs, MDFrom South Texas Veterans Health Care System, San Antonio, Texas, and Uniformed Services University of the Health Sciences, Bethesda, Maryland.Search for more papers by this author and Patrick G. O'Malley, MD, MPHFrom South Texas Veterans Health Care System, San Antonio, Texas, and Uniformed Services University of the Health Sciences, Bethesda, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-0522 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Drs. Tobert and Newman for the opportunity to highlight some important strengths and limitations of available data to inform patient-centered decisions. Data from randomized, controlled trials are important. However, it is axiomatic that such trials cannot be done to inform every aspect of every clinical decision, especially adverse effects. Data within a larger universe need to be considered, synthesized, and clinically applied to individual patients. These data include observational trials.The typical design of a published randomized trial has important limitations. These include generalizability due to inclusion criteria that exclude common comorbidities, the relatively short duration ...References1. Diamond DM, Ravnskov U. How statistical deception created the appearance that statins are safe and effective in primary and secondary prevention of cardiovascular disease. Expert Rev Clin Pharmacol. 2015;8:201-10. [PMID: 25672965] doi:10.1586/17512433.2015.1012494 CrossrefMedlineGoogle Scholar2. Psaty BM, Kronmal RA. Reporting mortality findings in trials of rofecoxib for Alzheimer disease or cognitive impairment: a case study based on documents from rofecoxib litigation. JAMA. 2008;299:1813-7. [PMID: 18413875] doi:10.1001/jama.299.15.1813 CrossrefMedlineGoogle Scholar3. Suppression of research data. In: Brody H. Hooked. Lanham, MD: Rowman & Littlefield; 2007:97-113 Google Scholar4. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002;360:7-22. [PMID: 12114036] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From South Texas Veterans Health Care System, San Antonio, Texas, and Uniformed Services University of the Health Sciences, Bethesda, Maryland.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOf InterestForms.do?msNum=M15-0840. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Dyslipidemia for Cardiovascular Disease Risk Reduction: Synopsis of the 2014 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline John R. Downs and Patrick G. O'Malley Management of Dyslipidemia for Cardiovascular Disease Risk Reduction Jonathan A. Tobert and Connie B. Newman Metrics Cited byNovel circulating lipid measurements for current dyslipidemias in non-treated patients undergoing coronary angiography: PCSK9, apoC3 and sdLDL-C 5 April 2016Volume 164, Issue 7Page: 509-510KeywordsAdverse eventsConflicts of interestDisclosureDyslipidemiaFood and Drug AdministrationHeart rateLongitudinal studiesRandomized trialsStatinsTreatment guidelines ePublished: 5 April 2016 Issue Published: 5 April 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...