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To the Editor: Dr Ornish and colleagues¹ report that intensive lifestyle changes without lipid-lowering drugs may induce reversal of coronary heart disease. This study is described as a randomized controlled trial, but the characteristics of the control group are uncertain.

The trial was conducted between 1986 and 1992 and all subjects at entry were not taking lipid-lowering drugs.² The findings reported at 1 year indeed showed no meaningful changes in lipid levels in the control group. Ornish has stated, however, that he "went over their [control group] results with them after a year and invited them to attend a retreat to learn our program. Surprisingly, only a third of them did. Two have made changes comparable to those of the experimental group, about seven are making moderate changes, and the rest are doing pretty much what they were doing before."³ This statement directly contradicts the JAMA article,¹ which states, "control . . . [Full Text of this Article]