Commentary on the Published Results of the Lipid Research Clinics Coronary Primary Prevention Trial

Excerpt

THE LIPID Research Clinics Coronary Primary Prevention Trial (LRC-CPPT) was a randomized double-blind clinical trial testing the efficacy of the cholesterollowering drug cholestyramine taken in conjunction with a cholesterol-lowering diet in reducing the risk of coronary heart disease (CHD) in asymptomatic middle-aged men with primary hypercholesterolemia. The CPPT trial results were described in detail in two recent articles in The Journal.^1,2 The first article presented the results of the clinical trial itself, comparing the occurrence of cardiovascular disease in the two study groups: (1) cholestyramine plus diet and (2) placebo plus diet. The second article analyzed data from the two groups separately and within each group examined the relationship of lowering of levels of total cholesterol and of low-density lipoprotein-cholesterol (LDL-C) to the incidence of primary cardiovascular end points. The trial was well designed and superbly carried out. However, the reported conclusions seem to go beyond what is reasonably