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The Lipid Research Clinics Program

JAMA. 1985;253(21):3090-3091.

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In Reply.—

Dr Adams is correct to point out that a statistical association of lower plasma cholesterol levels and reduced incidence of CHD need not imply that these findings are cause and effect. However, his speculations concerning the mechanism of this association are based, at least in part, on a misreading of the LRC-CPPT results. The statistic on which he bases his third conclusion that "cholestyramine dosage is not related to CHD frequency" was derived from a proportional-hazards model containing terms for both change in LDL cholesterol and packet count. The nonsignificance (P>.85) of the pack et-count term in this model implied the absence of a non-LDL—mediated effect of cholestyramine dosage on CHD incidence. When the term for change in LDL cholesterol levels was omitted from the model,¹ the term for packet count was significant (P=.037, for a one-sided alternative). These two models taken together demonstrate an . . . [Full Text PDF of this Article]

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