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Cholesterol Reduction: Weighing the Benefits and Risks
- J. Michael Gaziano, MD, MPH;
- Patricia R. Hebert, PhD; and
- Charles H. Hennekens, MD, DrPH
- From Brigham and Women's Hospital, Harvard Medical School, and Harvard School of Public Health, Boston, Massachusetts, and the Veterans Affairs Medical Center, West Roxbury, Massachusetts. Acknowledgments: The authors thank Anne T. Cadigan for help in manuscript preparation. Requests for Reprints: J. Michael Gaziano, MD, Brigham and Women's Hospital, Division of Preventive Medicine, 900 Commonwealth Avenue East, Boston, MA 02215-1204. Current Author Addresses: Drs. Gaziano, Hebert, and Hennekens: Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215-1204.
Abstract
The National Cholesterol Education Program recommends reducing total and low-density lipoprotein cholesterol levels to decrease the risk for coronary heart disease. The available evidence clearly indicates that higher cholesterol levels increase the risk for coronary heart disease and that cholesterol reduction results in corresponding decreases in risk. In contrast, existing data do not strongly support the idea that cholesterol reduction causes increases in any specific nonvascular cause of death. The outcomes of ongoing, large-scale trials will enable existing guidelines to be refined. However, current recommendations, which encourage nonpharmacologic interventions for about 30% of U.S. adults and cholesterol-reducing drugs for about 7% of U.S. adults, seem both justified and warranted.
- Copyright ©2004 by the American College of Physicians
