Rationale to Treat
The weight of evidence from primary and secondary prevention clinical trials indicates that reduction of low-density lipoprotein cholesterol (LDLC) levels by diets, drugs, or other means can decrease the incidence of fatal and nonfatal myocardial infarction. A series of angiographic trials have demonstrated that reduced mortality and morbidity from LDL-C reduction are attributable, at least in part, to stabilization and regression of coronary atherosclerosis in both native vascular beds and venous bypass grafts. These studies provide the rationale for treatment of hyperlipoproteinemia with the goal of preventing coronary heart disease. Evidence from human clinical trials is supported by an extensive series of experiments in atherosclerotic animals of many species, including nonhuman primates. This review of treatment rationale summarizes evidence from human mortality and morbidity-based trials, human angiographic trials, and experimental animal models.
KeywordsPlacebo Cholesterol Cardiol Triglyceride Renin
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