BMJ 1994;308:1038-1041 (16 April)

Letters

Ischaemic heart disease and cholesterol There's more to heart disease than cholesterol

EDITOR, - We are impressed by the "cholesterol papers."*RF 1-3* M R Law and colleagues prove that it is highly probable that lowering the serum cholesterol concentration in the population will reduce the risk of ischaemic heart disease without increasing the risk of other disease. The jump from epidemiological evidence to conclusions regarding public health is not, however, as evident as they suggest.

Law and colleagues state that lowering serum cholesterol concentration is critical in reducing ischaemic heart disease. It certainly was not so in the past; why should it be in the future? Several Western populations have seen a steeply decreasing mortality from ischaemic heart disease in association with constant or even increasing cholesterol concentrations.4 If we compare the cohort of the British United Provident Association (BUPA), which was recruited in 1975-82, with the Whitehall cohort, which was recruited one decade earlier, we observe higher serum cholesterol concentrations in . . . [Full text of this article]


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Relevant Article

Systematic underestimation of association between serum cholesterol concentration and ischaemic heart disease in observational studies: data from the BUPA study
M R Law, N J Wald, T Wu, A Hackshaw, and A Bailey
BMJ 1994 308: 363-366. [Abstract] [Full Text]

This article has been cited by other articles:

  • Gould, A. L., Rossouw, J. E., Santanello, N. C., Heyse, J. F., Furberg, C. D. (1995). Cholesterol Reduction Yields Clinical Benefit : A New Look at Old Data. Circulation 91: 2274-2282 [Abstract] [Full text]  
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