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Daniel M. Lane, MD, PhD
Oklahoma Medical Research Foundation Oklahoma City

JAMA. 1993;270(8):936.

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

To the Editor.

—The conclusions drawn by Hulley et al¹ are another example of the improper use of epidemiologic data to oppose treatment of hypercholesterolemic patients because they ignore critical observations:

1. Morbidity due to coronary heart disease (CHD) costs more than CHD mortality. The American Heart Association estimated that for 1992 the loss of productivity due to disability from cardiovascular diseases was $17 billion, an amount exceeding the combined costs for physicians' and nurses' services.²
   
2. The report by Klag et al³ found that increased serum cholesterol levels in young adult men were associated with cardiovascular disease during midlife. Increased baseline serum cholesterol levels in young men (mean age, 22 years) were significantly related to increased cardiovascular disease, presence of CHD, and death due to cardiovascular disease 30 years later.
   Most importantly, Hulley et al failed to separate the use of serum total cholesterol levels for screening from the use
   

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