You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT JAMA
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 251 No. 3, January 20, 1984 TABLE OF CONTENTS
  JAMA
  •  Online Features
  ORIGINAL CONTRIBUTIONS
 This Article
 •References
 •Full text PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Contact me when this article is cited
 Related Content
 •Similar articles in JAMA
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit Add to Technorati Add to Twitter What's this?

The Lipid Research Clinics Coronary Primary Prevention Trial Results

II. The Relationship of Reduction in Incidence of Coronary Heart Disease to Cholesterol Lowering

Lipid Research Clinics Program

JAMA. 1984;251(3):365-374.


Abstract

In the Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT), a 19% lower incidence of coronary heart disease (CHD) in cholestyramine-treated men was accompanied by mean falls of 8% and 12% in plasma total (TOTAL-C) and low-density lipoprotein (LDL-C) cholesterol levels relative to levels in placebo-treated men. When the cholestyramine treatment group was analyzed separately, a 19% reduction in CHD risk was also associated with each decrement of 8% in TOTAL-C or 11% in LDL-C levels (P<.001). Moreover, CHD incidence in men sustaining a fall of 25% in TOTAL-C or 35% in LDL-C levels, typical responses to the prescribed dosage (24 g/day) of cholestyramine resin, was half that of men who remained at pretreatment levels. Adherence to medication was associated with reduced incidence of CHD only when accompanied by falls in TOTAL-C and LDL-C levels. Small increases in high-density lipoprotein cholesterol levels, which accompanied cholestyramine treatment, independently accounted for a 2% reduction in CHD risk. Thus, the reduction of CHD incidence in the cholestyramine group seems to have been mediated chiefly by reduction of TOTAL-C and LDL-C levels.

(JAMA 1984;251:365-374)



Author Affiliations

From the Lipid Metabolism-Atherogenesis Branch, National Heart, Lung, and Blood Institute, Bethesda, Md.


Footnotes

Reprint requests to Lipid Metabolism-Atherogenesis Branch, National Heart, Lung, and Blood Institute, Federal 401, Bethesda, MD 20205 (Basil M. Rifkind, MD).



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Bile Acids and Metabolic Regulation: Mechanisms and clinical responses to bile acid sequestration
Staels and Fonseca
Diabetes Care 2009;32:S237-S245.
FULL TEXT  

Evaluating the Incremental Benefits of Raising High-Density Lipoprotein Cholesterol Levels During Lipid Therapy After Adjustment for the Reductions in Other Blood Lipid Levels
Grover et al.
Arch Intern Med 2009;169:1775-1780.
ABSTRACT | FULL TEXT  

Lipid Profile, Low-Density Lipoprotein Oxidation and Ceruloplasmin in the Progeny of Families With a Positive History of Cardiovascular Diseases and/or Hyperlipidemia
Makedou et al.
ANGIOLOGY 2009;60:455-461.
ABSTRACT  

Long-Term Renal Function and Cardiovascular Disease Risk in Obese Kidney Donors
Tavakol et al.
CJASN 2009;4:1230-1238.
ABSTRACT | FULL TEXT  

History of the cholesterol controversy in Britain
Thompson
QJM 2009;102:81-86.
ABSTRACT | FULL TEXT  

Response to Letter of Mascitelli L, Ravnskov U, Pezzetta F, and Goldstein M
Whayne
ANGIOLOGY 2009;60:129-130.
 

Meta-analysis of the relationship between non-high-density lipoprotein cholesterol reduction and coronary heart disease risk.
Robinson et al.
J Am Coll Cardiol 2009;53:316-322.
ABSTRACT | FULL TEXT  

Is There a Problem With Ezetimibe or Just ENHANCEd Hype?
Whayne
ANGIOLOGY 2009;59:661-663.
 

Simvastatin with or without ezetimibe in familial hypercholesterolemia.
Steinberg et al.
NEJM 2008;359:529-530.
FULL TEXT  

Dietary Fiber and the Relationship to Chronic Diseases
Timm and Slavin
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2008;2:233-240.
ABSTRACT  

Toward 'Pain-Free' Statin Prescribing: Clinical Algorithm for Diagnosis and Management of Myalgia
Jacobson
Mayo Clin Proc. 2008;83:687-700.
ABSTRACT | FULL TEXT  

Is There a Role for Fibrates in the Management of Dyslipidemia in the Metabolic Syndrome?
Barter and Rye
Arterioscler. Thromb. Vasc. Bio. 2008;28:39-46.
ABSTRACT | FULL TEXT  

State of the Art Reviews: Relationship Between Diet/ Physical Activity and Health
O'Neil and Nicklas
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2007;1:457-481.
ABSTRACT  

Glucuronidation Converting Methyl 1-(3,4-Dimethoxyphenyl)-3-(3-ethylvaleryl)-4-hydroxy-6,7,8-trimethoxy-2-naphthoate (S-8921) to a Potent Apical Sodium-Dependent Bile Acid Transporter Inhibitor, Resulting in a Hypocholesterolemic Action
Sakamoto et al.
J. Pharmacol. Exp. Ther. 2007;322:610-618.
ABSTRACT | FULL TEXT  

The Unique Character of Cardiovascular Disease in Chronic Kidney Disease and Its Implications for Treatment with Lipid-Lowering Drugs
Nogueira and Weir
CJASN 2007;2:766-785.
ABSTRACT | FULL TEXT  

Nonfasting Low-Density Lipoprotein Testing: Utility for Cholesterol Screening in Pediatric Primary Care
de Ferranti et al.
CLIN PEDIATR 2007;46:441-445.
ABSTRACT  

Optimal Low-Density Lipoprotein Cholesterol Lowering-- Morning Versus Evening Statin Administration
Plakogiannis and Cohen
The Annals of Pharmacotherapy 2007;41:106-110.
ABSTRACT | FULL TEXT  

A 39-year-old woman with hypercholesterolemia.
Mittleman
JAMA 2006;296:319-326.
ABSTRACT | FULL TEXT  

THE GREAT DEBATE EDITORIAL, REVISITED: RESPONSE
Freedland et al.
Psychosom. Med. 2006;68:638-640.
FULL TEXT  

Vascular Biomarkers and Surrogates in Cardiovascular Disease
Tardif et al.
Circulation 2006;113:2936-2942.
ABSTRACT | FULL TEXT  

Profiling risk: the emergence of coronary heart disease epidemiology in the United States (1947-70)
Oppenheimer
Int J Epidemiol 2006;35:720-730.
ABSTRACT | FULL TEXT  

Role of the Pharmacist in the Management of Dyslipidemia
Olson and Potts
Journal of Pharmacy Practice 2006;19:94-102.
ABSTRACT  

Thematic review series: The Pathogenesis of Atherosclerosis. An interpretive history of the cholesterol controversy, part IV: The 1984 Coronary Primary Prevention Trial ends it--almost
Steinberg
J. Lipid Res. 2006;47:1-14.
ABSTRACT | FULL TEXT  

Stimulation of Liver-Directed Cholesterol Flux in Mice by Novel N-Acetylgalactosamine-Terminated Glycolipids With High Affinity for the Asialoglycoprotein Receptor
Rensen et al.
Arterioscler. Thromb. Vasc. Bio. 2006;26:169-175.
ABSTRACT | FULL TEXT  

High-Dose Atorvastatin vs Usual-Dose Simvastatin for Secondary Prevention After Myocardial Infarction: The IDEAL Study: A Randomized Controlled Trial
Pedersen et al.
JAMA 2005;294:2437-2445.
ABSTRACT | FULL TEXT  

The Farnesoid X Receptor: A Molecular Link Between Bile Acid and Lipid and Glucose Metabolism
Claudel et al.
Arterioscler. Thromb. Vasc. Bio. 2005;25:2020-2030.
ABSTRACT | FULL TEXT  

Anorectics on Trial: A Half Century of Federal Regulation of Prescription Appetite Suppressants
Colman
ANN INTERN MED 2005;143:380-385.
ABSTRACT | FULL TEXT  

Patient Adherence Improves Glycemic Control
Rhee et al.
The Diabetes Educator 2005;31:240-250.
ABSTRACT | FULL TEXT  

Thematic review series: The Pathogenesis of Atherosclerosis. An interpretive history of the cholesterol controversy: part II: the early evidence linking hypercholesterolemia to coronary disease in humans
Steinberg
J. Lipid Res. 2005;46:179-190.
ABSTRACT | FULL TEXT  

Pathogenesis of Atherosclerosis
Crowther
ASH Education Book 2005;2005:436-441.
ABSTRACT | FULL TEXT  

Addressing Cardiovascular Disease in Women: Focus on Dyslipidemia
Meagher
J Am Board Fam Med 2004;17:424-437.
ABSTRACT | FULL TEXT  

Clinical Chemistry Journal Has Contributed to Progress in Lipid and Lipoprotein Testing for Fifty Years
Rifai et al.
Clin. Chem. 2004;50:1861-1870.
FULL TEXT  

CYP7A1 A-278C Polymorphism Affects the Response of Plasma Lipids after Dietary Cholesterol or Cafestol Interventions in Humans
Hofman et al.
J. Nutr. 2004;134:2200-2204.
ABSTRACT | FULL TEXT  

The Toxicology of HMG--CoA Reductase Inhibitors: Prediction of Human Risk
MacDonald and Halleck
Toxicol Pathol 2004;32:26-41.
ABSTRACT  

Endothelial dysfunction in young patients with rheumatoid arthritis and low disease activity
Vaudo et al.
Ann Rheum Dis 2004;63:31-35.
ABSTRACT | FULL TEXT  

Soy Protein Enhances the Cholesterol-Lowering Effect of Plant Sterol Esters in Cholesterol-Fed Hamsters
Lin et al.
J. Nutr. 2004;134:143-148.
ABSTRACT | FULL TEXT  

Relation Between Progression and Regression of Atherosclerotic Left Main Coronary Artery Disease and Serum Cholesterol Levels as Assessed With Serial Long-Term (>=12 Months) Follow-Up Intravascular Ultrasound
von Birgelen et al.
Circulation 2003;108:2757-2762.
ABSTRACT | FULL TEXT  

The Northern Sweden MONICA project: concluding remarks
Asplund and Wall
Scand J Public Health 2003;31:78-84.
 

Efficacy and Safety of Plant Stanols and Sterols in the Management of Blood Cholesterol Levels
Katan et al.
Mayo Clin Proc. 2003;78:965-978.
ABSTRACT  

DAIS: how it relates to other lipid intervention studies in diabetes
Steiner
British Journal of Diabetes & Vascular Disease 2003;3:212-215.
ABSTRACT  

Medicine partnerships
Cramer
Heart 2003;89:ii19-21.
ABSTRACT | FULL TEXT  

Donald Sharp Fredrickson, MD: 1924-2002
Gotto
Circulation 2003;107:1714-1716.
FULL TEXT  

Effects of ezetimibe, a new cholesterol absorption inhibitor, on plasma lipids in patients with primary hypercholesterolemia
Knopp et al.
Eur Heart J 2003;24:729-741.
ABSTRACT | FULL TEXT  

Differential Effects of Lipid-Lowering Therapies on Stroke Prevention: A Meta-analysis of Randomized Trials
Corvol et al.
Arch Intern Med 2003;163:669-676.
ABSTRACT | FULL TEXT  

Automating Complex Guidelines for Chronic Disease: Lessons Learned
Maviglia et al.
J. Am. Med. Inform. Assoc. 2003;10:154-165.
ABSTRACT | FULL TEXT  

References
Circulation 2002;106:3373-3421.
FULL TEXT  

Inhibition of the Apical Sodium-Dependent Bile Acid Transporter Reduces LDL Cholesterol and ApoB by Enhanced Plasma Clearance of LDL ApoB
Huff et al.
Arterioscler. Thromb. Vasc. Bio. 2002;22:1884-1891.
ABSTRACT | FULL TEXT  

Donald S. Fredrickson, MD: 1924-2002
Gotto
Arterioscler. Thromb. Vasc. Bio. 2002;22:1506-1508.
FULL TEXT  

Hypertensive retinopathy and incident coronary heart disease in high risk men
Duncan et al.
Br J Ophthalmol 2002;86:1002-1006.
ABSTRACT | FULL TEXT  

Whole-grain intake is favorably associated with metabolic risk factors for type 2 diabetes and cardiovascular disease in the Framingham Offspring Study
McKeown et al.
Am. J. Clin. Nutr. 2002;76:390-398.
ABSTRACT | FULL TEXT  

Safety and Tolerability of Pravastatin in Long-Term Clinical Trials: Prospective Pravastatin Pooling (PPP) Project
Pfeffer et al.
Circulation 2002;105:2341-2346.
ABSTRACT | FULL TEXT  

Disparities in the Diagnosis and Pharmacologic Treatment of High Serum Cholesterol by Race and Ethnicity: Data From the Third National Health and Nutrition Examination Survey
Nelson et al.
Arch Intern Med 2002;162:929-935.
ABSTRACT | FULL TEXT  

A Community-Wide Survey of Physician Practices and Attitudes Toward Cholesterol Management in Patients With Recent Acute Myocardial Infarction
Yarzebski et al.
Arch Intern Med 2002;162:797-804.
ABSTRACT | FULL TEXT  

Effect of a Rapeseed Oil Substituting Diet on Serum Lipids and Lipoproteins in Children and Adolescents with Familial Hypercholesterolemia
Gulesserian and Widhalm
J. Am. Coll. Nutr. 2002;21:103-108.
ABSTRACT | FULL TEXT  

Why some patients respond poorly to statins and how this might be remedied
Thompson et al.
Eur Heart J 2002;23:200-206.
FULL TEXT  

Lipoproteins, nutrition, and heart disease
Schaefer
Am. J. Clin. Nutr. 2002;75:191-212.
ABSTRACT | FULL TEXT  

Methods for Measurement of LDL-Cholesterol: A Critical Assessment of Direct Measurement by Homogeneous Assays versus Calculation
Nauck et al.
Clin. Chem. 2002;48:236-254.
ABSTRACT | FULL TEXT  

Antioxidant Supplements Block the Response of HDL to Simvastatin-Niacin Therapy in Patients With Coronary Artery Disease and Low HDL
Cheung et al.
Arterioscler. Thromb. Vasc. Bio. 2001;21:1320-1326.
ABSTRACT | FULL TEXT  

Fluvastatin inhibits O2- and ICAM-1 levels in a rat model with aortic remodeling induced by pressure overload
Katoh et al.
Am. J. Physiol. Heart Circ. Physiol. 2001;281:H655-H660.
ABSTRACT | FULL TEXT  

Lipid responses to plant-sterol-enriched reduced-fat spreads incorporated into a National Cholesterol Education Program Step I diet
Maki et al.
Am. J. Clin. Nutr. 2001;74:33-43.
ABSTRACT | FULL TEXT  

A Novel Test for the Measurement of Skin Cholesterol
Zawydiwski et al.
Clin. Chem. 2001;47:1302-1304.
FULL TEXT  

Temporal Trends (1986-1997) in Cholesterol Level Assessment and Management Practices in Patients With Acute Myocardial Infarction: A Population-Based Perspective
Yarzebski et al.
Arch Intern Med 2001;161:1521-1528.
ABSTRACT | FULL TEXT  

Coffee Consumption and Serum Lipids: A Meta-Analysis of Randomized Controlled Clinical Trials
Jee et al.
Am J Epidemiol 2001;153:353-362.
ABSTRACT | FULL TEXT  

Dietary fat intakes in infants and primary school children in Germany
Koletzko et al.
Am. J. Clin. Nutr. 2000;72 :1392S-1398S.
ABSTRACT | FULL TEXT  

A Reference Method Laboratory Network for Cholesterol: A Model for Standardization and Improvement of Clinical Laboratory Measurements
Myers et al.
Clin. Chem. 2000;46:1762-1772.
ABSTRACT | FULL TEXT  

Use of lipid lowering drugs for primary prevention of coronary heart disease: meta-analysis of randomised trials
Pignone et al.
BMJ 2000;321:983-986.
ABSTRACT | FULL TEXT  

Analytical and Clinical Evaluation of Two Homogeneous Assays for LDL-Cholesterol in Hyperlipidemic Patients
Esteban-Salan et al.
Clin. Chem. 2000;46:1121-1131.
ABSTRACT | FULL TEXT  

Do Triglycerides Provide Meaningful Information About Heart Disease Risk?
Avins and Neuhaus
Arch Intern Med 2000;160:1937-1944.
ABSTRACT | FULL TEXT  

Multiple mechanisms, independent of sterol regulatory element binding proteins, regulate low density lipoprotein gene transcription
Makar et al.
J. Lipid Res. 2000;41:762-774.
ABSTRACT | FULL TEXT  

Consumption of Soy Protein Reduces Cholesterol Absorption Compared to Casein Protein Alone or Supplemented with an Isoflavone Extract or Conjugated Equine Estrogen in Ovariectomized Cynomolgus Monkeys
Greaves et al.
J. Nutr. 2000;130:820-826.
ABSTRACT | FULL TEXT  

Hereditary dyslipidaemias and combined risk factors in children with a family history of premature coronary artery disease
Sveger et al.
Arch. Dis. Child. 2000;82:292-296.
ABSTRACT | FULL TEXT  

Cholesterol Screening in Children and Adolescents
Newman and MD
Pediatrics 2000;105:637-638.
FULL TEXT  

The Colorado Thyroid Disease Prevalence Study
Canaris et al.
Arch Intern Med 2000;160:526-534.
ABSTRACT | FULL TEXT  

The association of resting heart rate with cardiovascular, cancer and all-cause mortality. Eight year follow-up of 3527 male Israeli employees (the CORDIS Study)
Kristal-Boneh et al.
Eur Heart J 2000;21:116-124.
ABSTRACT  

Effects of hydroxymethylglutaryl coenzyme A reductase inhibitor simvastatin on smooth muscle cell proliferation in vitro and neointimal formation in vivo after vascular injury
Indolfi et al.
J Am Coll Cardiol 2000;35:214-221.
ABSTRACT | FULL TEXT  

Colesevelam Hydrochloride (Cholestagel): A New, Potent Bile Acid Sequestrant Associated With a Low Incidence of Gastrointestinal Side Effects
Davidson et al.
Arch Intern Med 1999;159:1893-1900.
ABSTRACT | FULL TEXT  

Increased Cerebral CO2 Reactivity After Heparin-Mediated Extracorporal LDL Precipitation (HELP) in Patients With Coronary Heart Disease and Hyperlipidemia
Pfefferkorn et al.
Stroke 1999;30 :e1802-1806.
ABSTRACT | FULL TEXT  

Drug Treatment of Lipid Disorders
Knopp
NEJM 1999;341:498-511.
FULL TEXT  

Cholesterol Lowering in the Elderly Population
Grundy et al.
Arch Intern Med 1999;159:1670-1678.
ABSTRACT | FULL TEXT  

Plasma lipid changes after supplementation with {beta}-glucan fiber from yeast
Nicolosi et al.
Am. J. Clin. Nutr. 1999;70:208-212.
ABSTRACT | FULL TEXT  

Intact Dietary Soy Protein, but Not Adding an Isoflavone-Rich Soy Extract to Casein, Improves Plasma Lipids in Ovariectomized Cynomolgus Monkeys
Greaves et al.
J. Nutr. 1999;129:1585-1592.
ABSTRACT | FULL TEXT  

Coronary Calcium Does Not Accurately Predict Near-Term Future Coronary Events in High-Risk Adults
Detrano et al.
Circulation 1999;99:2633-2638.
ABSTRACT | FULL TEXT  

Evidence for a New Pathophysiological Mechanism for Coronary Artery Disease Regression : Hepatic Lipase–Mediated Changes in LDL Density
Zambon et al.
Circulation 1999;99:1959-1964.
ABSTRACT | FULL TEXT  

Forecasting Patient Outcomes in the Management of Hyperlipidemia
Brier et al.
Arch Intern Med 1999;159:569-575.
ABSTRACT | FULL TEXT  

Cost-effectiveness of 3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Inhibitors in the Secondary Prevention of Cardiovascular Disease: Forecasting the Incremental Benefits of Preventing Coronary and Cerebrovascular Events
Grover et al.
Arch Intern Med 1999;159:593-600.
ABSTRACT | FULL TEXT  

National Trends in the Management of Cardiovascular Disease Risk Factors in Children: Second NHLBI Survey of Primary Care Physicians
Kimm et al.
Pediatrics 1998;102:50e-50.
ABSTRACT | FULL TEXT  

Randomized Trial of Estrogen Plus Progestin for Secondary Prevention of Coronary Heart Disease in Postmenopausal Women
Hulley et al.
JAMA 1998;280:605-613.
ABSTRACT | FULL TEXT  

Physical Activity Improves the Metabolic Risk Profiles in Men and Women: The Tromso Study
Thune et al.
Arch Intern Med 1998;158:1633-1640.
ABSTRACT | FULL TEXT  

Inhibition of Ileal Na+/Bile Acid Cotransporter by S-8921 Reduces Serum Cholesterol and Prevents Atherosclerosis in Rabbits
Higaki et al.
Arterioscler. Thromb. Vasc. Bio. 1998;18:1304-1311.
ABSTRACT | FULL TEXT  

Influence of Pravastatin and Plasma Lipids on Clinical Events in the West of Scotland Coronary Prevention Study (WOSCOPS)
Circulation 1998;97:1440-1445.
ABSTRACT | FULL TEXT  

Relationship Between Plasma LDL Concentrations During Treatment With Pravastatin and Recurrent Coronary Events in the Cholesterol and Recurrent Events Trial
Sacks et al.
Circulation 1998;97:1446-1452.
ABSTRACT | FULL TEXT  

Lipoprotein Changes and Reduction in the Incidence of Major Coronary Heart Disease Events in the Scandinavian Simvastatin Survival Study (4S)
Pedersen et al.
Circulation 1998;97:1453-1460.
ABSTRACT | FULL TEXT  

Serum Cholesterol Distribution and Coronary Heart Disease Risk : Observations and Predictions Among Middle-aged Population in Eastern Finland
Jousilahti et al.
Circulation 1998;97:1087-1094.
ABSTRACT | FULL TEXT  

Estimating the Benefits of Modifying Risk Factors of Cardiovascular Disease: A Comparison of Primary vs Secondary Prevention
Grover et al.
Arch Intern Med 1998;158:655-662.
ABSTRACT | FULL TEXT  

Relationships of Abdominal Obesity and Hyperinsulinemia to Angiographically Assessed Coronary Artery Disease in Men With Known Mutations in the LDL Receptor Gene
Gaudet et al.
Circulation 1998;97:871-877.
ABSTRACT | FULL TEXT  

Treating Hyperlipidemia for the Primary Prevention of Coronary Disease: Are Higher Dosages of Lovastatin Cost-effective?
Perreault et al.
Arch Intern Med 1998;158:375-381.
ABSTRACT | FULL TEXT  

Overexpression of Cholesterol 7alpha -Hydroxylase (CYP7A) in Mice Lacking the Low Density Lipoprotein (LDL) Receptor Gene. LDL TRANSPORT AND PLASMA LDL CONCENTRATIONS ARE REDUCED
Spady et al.
J. Biol. Chem. 1998;273:126-132.
ABSTRACT | FULL TEXT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1984 American Medical Association. All Rights Reserved.