Advertisement

Drugs

, Volume 31, Supplement 1, pp 53–60 | Cite as

The Lipid Research Clinics Coronary Primary Prevention Trial

  • B. M. Rifkind
Article

Summary

The Lipid Research Clinics Coronary Primary Prevention Trial tested the efficacy of cholesterol lowering in reducing the risk of coronary heart disease in 3806 asymptomatic, middle-aged men with primary hypercholesterolaemia. The cholestyramine group experienced 8.5 and 12.6% greater reductions in total and low density lipoprotein (LDL), respectively, than those obtained in the placebo group. The cholestyramine group experienced a 19% reduction in risk (p < 0.05) of the primary end-point of definite coronary heart disease death and/or definite non-fatal myocardial infarction. Corresponding and significant reductions were also seen for angina, development of a positive exercise test, and coronary bypass surgery. All-cause mortality was only slightly, and not significantly, reduced in the cholestyramine group, reflecting more violent and accidental deaths in the cholestyramine subjects.

When the cholestyramine group was analysed separately, a 19% reduction in coronary heart disease risk was also associated with each decrement of 8% in total cholesterol. Moreover, coronary heart disease incidence in men in sustaining a fall of 25% in total cholesterol, a typical response to the prescribed dosage (24 g/day) of cholestyramine resin, was half that of men who remained at pretreatment level.

The Lipid Research Clinics Coronary Primary Prevention Trial findings show that reducing total cholesterol by lowering LDL cholesterol levels, can diminish the incidence of coronary heart disease morbidity and mortality in men at high risk for the disease because of raised LDL cholesterol levels. These results have considerable importance for the prevention of coronary heart disease through cholesterol lowering, at both the clinical and public health levels.

Keywords

Cholesterol Coronary Heart Disease Coronary Heart Disease Risk Cholesterol Lowering Blood Cholesterol Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Arteriosclerosis: A Report by the National Heart and Lung Institute Task Force on Arteriosclerosis. National Institutes of Health. DHEW Publication No. (NIH), 72–137, 1971Google Scholar
  2. Consensus Statement. Lowering blood cholesterol to prevent heart disease. Journal of the American Medical Association 253: 2080–2086, 1985CrossRefGoogle Scholar
  3. Cornfield J, Mitchell S. Selected risk factors in coronary disease. Possible intervention effects. Archives of Environmental Health 19: 382–391, 1969PubMedGoogle Scholar
  4. Inter-Society Commission for Heart Disease Resources. Report: optimal resources for primary prevention of atherosclerotic diseases. Circulation 7: 155A-2050A, 1984Google Scholar
  5. Kannel WB, Castelli WP, Gordon T, et al. Serum cholesterol, lipoproteins, and the risk of coronary heart disease. The Framingham Study. Annals of Internal Medicine 74: 1–12, 1971PubMedGoogle Scholar
  6. Lipid Research Clinics Program. The Coronary Primary Prevention Trial: design and implementation. Journal of Chronic Diseases 32: 609–663, 1979CrossRefGoogle Scholar
  7. Lipid Research Clinics Program. Pre-entry characteristics of participants in the Lipid Research Clinics Coronary Primary Prevention Trial. Journal of Chronic Diseases 36: 467–479, 1983CrossRefGoogle Scholar
  8. Lipid Research Clinics Program. The Lipid Research Clinics Coronary Primary Prevention Trial Results: I. Reduction in incidence of coronary heart disease II. The relativity of reduction in incidence of coronary heart disease to cholesterol lowering. Journal of the American Medical Association 251: 351–364 and 365–374, 1984CrossRefGoogle Scholar
  9. Mann JI, Marr JW. Coronary heart disease prevention: trials of diets to control hyperlipidemia. In Miller & Lewis (Eds) Atherosclerosis, lipoproteins, and coronary heart disease, pp. 197–210, Elsevier/North Holland Biomedical Press, Amsterdam, 1981Google Scholar

Copyright information

© ADIS Press Limited 1986

Authors and Affiliations

  • B. M. Rifkind
    • 1
  1. 1.Lipid Metabolism-Atherogenesis Branch, Division of Heart and Vascular Diseases, National HeartLung and Blood Institute, National Institutes of HealthBethesdaUSA

Personalised recommendations