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The Great Debate of 2008—How Low to Go in Preventive Cardiology?
Eric D. Peterson, MD, MPH;
Tracy Y. Wang, MD, MS
JAMA. 2008;299(14):1718-1720.
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The debates of 2008 have already been quite intense. During this election year, politicians and pundits alike, reviewing the same set of information, have formulated remarkably different conclusions and recommendations for national policy. The field of preventive cardiology has likewise been witness to its own debate. Spurred by a series of important yet somewhat unexpected clinical trial results, the question of "how low to go" in cardiovascular risk-factor modification has been hotly disputed.
This debate is not new and traditionally has been waged between the "true believers," those with a strong a priori conviction that more aggressive pharmacological treatment will reduce future events, and the "therapeutic nihilists," those who require unequivocal proof before acceptance. In recent years, the true believers have had the upper hand. Epidemiologic data have consistently concluded that lower levels of lipids, blood pressure, and glucose all . . . [Full Text of this Article]
Author Affiliations: Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina. Dr Peterson is also Contributing Editor, JAMA.
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