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To the Editor: The authors of the lipid-lowering trial component of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)¹ reported that the prescription of 20 to 40 mg/d of pravastatin achieved a 17% reduction in low-density lipoprotein (LDL) cholesterol levels but did not produce any benefit in mortality or coronary heart disease (CHD) events after a mean follow-up of 4.8 years. The authors concluded that their data "should be interpreted as consistent with current recommendations for cholesterol control in the prevention and treatment of cardiovascular disease." Because current recommendations for cholesterol control for persons without known CHD² are based on several key assumptions that were untested until ALLHAT-LLT, the negative results of this trial actually undermine these recommendations.

In reaching their conclusion, the ALLHAT-LLT authors cited unpublished data from which they constructed their Figure 5A, a graph that represents the log odds for all-cause mortality as a . . . [Full Text of this Article]

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