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C. R. Kumana, FRCP; B. M. Y. Cheung, MRCP; I. J. Lauder, PhD

JAMA. 1999;282:1899-1901.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The first evidence-based guidelines to treat coronary heart disease (CHD) with lipid-lowering drug therapy^1-7 were largely based on findings from the Scandinavian Simvastatin Survival Study (4S),⁸ which involved secondary prevention in patients with CHD. Thus, intervention was indicated only in patients with (1) hypercholesterolemia and (2) increased risk of CHD. Conventionally, this entailed dietary manipulation followed, if necessary, by treatment with a statin drug. However, mounting evidence from several subsequently published, large-scale, randomized clinical trials involving long-term use of statins has important additional implications on clinical practice. Thus, the cardiovascular benefits of long-term intervention with statins have now been amply demonstrated in: (1) men with hyperlipidemia but no known CHD,⁹ (2) patients with CHD but without hyperlipidemia,^10-11 and (3) men and women with average total and low-density lipoprotein plasma cholesterol levels and no known CHD.¹² In summary, . . . [Full Text of this Article]

Author Affiliations: Departments of Medicine (Drs Kumana and Cheung) and Statistics (Dr Lauder), University of Hong Kong, Hong Kong.

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