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  Vol. 289 No. 16, April 23, 2003 TABLE OF CONTENTS
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Lipid-Lowering Therapy and Risk of Coronary Events

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

To the Editor: The authors of ALLHAT-LLT1 explored several possible reasons for the failure of lipid-lowering therapy to translate into any change in the risk of CHD. It is possible, however, that there may be a threshold value of the total cholesterol/HDL-C (high-density lipoprotein cholesterol) ratio, below which further lowering will not produce any significant reduction in CHD.2 The average baseline ratios in several studies were greater than 5, which may be a critical value. Following treatment there was a significant reduction in CHD, especially in those studies that reported a ratio less than 5. Particularly noteworthy were the VA-HIT results, in which gemfibrozil produced a 24% decrease in CHD yet had no effect on LDL-C levels.3 The baseline ratio in ALLHAT-LLT was 4.67, so it is not surprising that further lowering of the ratio offered no CHD benefit. In the BIP study,4 a 41% reduction in CHD occurred in . . . [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)
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