Advice on reducing cholesterol should be included

BMJ 1995;310:466 (18 February)

Letters

Advice on reducing cholesterol should be included

EDITOR,--John McMurray and Andrew Rankin's review of treatmentof myocardial infarction and angina and subsequent advice onlifestyle modifications does not mention the advisability ofreducing cholesterol concentrations.¹ This is interesting giventhat large studies have shown cholesterol reduction to be effectivein inducing the regression of atheromatous plaques,² ³ fromwhich a reduction in subsequent deaths related to coronary heartdisease might be expected.

On the day that this paper was published the final results ofthe Scandinavian simvastatin survival study were announced.⁴They showed that after six years of follow up the relative riskof death related to coronary heart disease had fallen to 0.58(confidence interval 0.46 to 0.73). The trial design followedthe European Atherosclerosis Society's guidelines of reducingtotal cholesterol concentration to less than 5.2 mmol/l.⁵ Infact, the evidence for the efficacy of cholesterol reductionin the form of formal trials of both diet² and . . . [Full text of this article]

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