Monitoring Cholesterol Levels: Understanding Variance and Finding the Most Useful Data
Authors: William E. Cayley
Journal: Annals of Internal Medicine (2008)

Letters16 September 2008Monitoring Cholesterol Levels: Understanding Variance and Finding the Most Useful DataWilliam E. Cayley, MD, MDivWilliam E. Cayley, MD, MDivFrom University of Wisconsin School of Medicine and Public Health, Madison, WI 53705.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-6-200809160-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The study by Glasziou and colleagues (1) finds that “noise” random variations during serial cholesterol level monitoring may be greater than the change in cholesterol levels due to a therapeutic effect. This points to the importance of what exactly has been tested in cholesterol-lowering studies. Although guidelines and clinical practice often focus on titrating lipid treatment to obtain specified goal levels (2), the intervention that has actually been tested in many of the important statin trials is the administration of a fixed medium or high dose of a cholesterol-lowering medication. For example, the WOSCOPS (West of Scotland ...References1. Glasziou PP, Irwig L, Heritier S, Simes RJ, Tonkin A; LIPID Study Investigators. Monitoring cholesterol levels: measurement error or true change? Ann Intern Med. 2008;148:656-61. [PMID: 18458278] LinkGoogle Scholar2. Grundy SM, Cleeman JI, Merz CN, Brewer HB, Clark LT, Hunninghake DB, et al; National Heart, Lung, and Blood Institute. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004;110:227-39. [PMID: 15249516] CrossrefMedlineGoogle Scholar3. Influence of pravastatin and plasma lipids on clinical events in the West of Scotland Coronary Prevention Study (WOSCOPS). Circulation. 1998;97:1440-5. [PMID: 9576423] CrossrefMedlineGoogle Scholar4. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med. 1998;339:1349-57. [PMID: 9841303] CrossrefMedlineGoogle Scholar5. Ridker PM, Morrow DA, Rose LM, Rifai N, Cannon CP, Braunwald E. Relative efficacy of atorvastatin 80 mg and pravastatin 40 mg in achieving the dual goals of low-density lipoprotein cholesterol <70 mg/dl and C-reactive protein <2 mg/l: an analysis of the PROVE-IT TIMI-22 trial. J Am Coll Cardiol. 2005;45:1644-8. [PMID: 15893181] CrossrefMedlineGoogle Scholar6. Nissen SE, Tuzcu EM, Schoenhagen P, Crowe T, Sasiela WJ, Tsai J; Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) Investigators. Statin therapy, LDL cholesterol, C-reactive protein, and coronary artery disease. N Engl J Med. 2005;352:29-38. [PMID: 15635110] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Wisconsin School of Medicine and Public Health, Madison, WI 53705.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMonitoring Cholesterol Levels: Measurement Error or True Change? Paul P. Glasziou , Les Irwig , Stephane Heritier , R. John Simes , Andrew Tonkin , and Monitoring Cholesterol Levels: Understanding Variance and Finding the Most Useful Data Liu Hong , Kaichun Wu , and Daiming Fan Monitoring Cholesterol Levels: Understanding Variance and Finding the Most Useful Data Paul P. Glasziou and Les Irwig Monitoring Cholesterol Levels: Understanding Variance and Finding the Most Useful Data Justin W. Timbie Metrics 16 September 2008Volume 149, Issue 6Page: 436-437KeywordsAtherosclerosisCOVID-19CholesterolClinical trialsConflicts of interestInfectious diseasesLipidsStable coronary artery diseaseStatinsTreatment guidelines ePublished: 16 September 2008 Issue Published: 16 September 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...