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To the Editor: The ALLHAT-LLT authors concluded that "pravastatin did not reduce either all-cause mortality or CHD significantly."¹ This conclusion is misleading because it suggests that, despite considerable prior evidence that statins reduce CHD events, statins are not effective in this population, with this drug, or in this trial.

In fact, the data show that the effect of pravastatin on CHD events was exactly as expected from previous data. Figure 1 presents data from Table 5 of the ALLHAT-LLT article. The regression line is plotted from the 8 previous statin trials without the ALLHAT-LLT data. I have plotted percentage change in cholesterol as the independent variable and the odds of cardiovascular events as the dependent variable. The ALLHAT-LLT investigators found that pravastatin produced a 0.91 reduction in the risk of CHD events and a difference in total cholesterol of 9.6%. The reduction in CHD events expected from the regression equation, . . . [Full Text of this Article]

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Major Outcomes in Moderately Hypercholesterolemic, Hypertensive Patients Randomized to Pravastatin vs Usual Care: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)
The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group
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