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Kevin A. Shulman, MD; Bruce Kinosian, MD; Terry A. Jacobson, MD; Henry Glick, MA; John M. Eisenberg, MD
University of Pennsylvania Philadelphia

Harris Koffer, PharmD; Mary Kaye Willian, DrPH, RN
Philadelphia Association for Clinical Trials St Davids, Pa

JAMA. 1991;265(15):1950.

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

In Reply. —

Drs Bentkover, Boselli, and Lambird raise several issues concerning our article; the principal ones concern our construction of the LDL-HDL index, our analytic perspective, and the costs of side effects. We address these in turn.

Dr Bentkover correctly observes that the LDL-HDL index reported in Table 1 (p 3028) does not appear well calibrated; it finds gemfibrozil ( —16) to be almost equivalent to cholestyramine resin ( —14), yet the two long-term trials for these agents indicate substantially different reductions in CHD risk (34% vs 19%). Dr Boselli also faults our first index, arguing that Gordon's¹ observations indicate that elevations of HDL cholesterol levels and diminutions of LDL cholesterol levels have equivalent effects on CHD risk.

Neither author notes that we report on a second index in our sensitivity analysis. This index is better calibrated with the long-term trials (gemfibrozil, —15.5; cholestyramine resin, —10.9) and equates the effects . . . [Full Text PDF of this Article]

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