Cholesterol and coronary disease--outstanding questions.
Established facts include the role of raised blood cholesterol in causing coronary atheroma and that a high dietary intake of saturated fat is a leading cause of coronary disease. It is also clear that reduction of hypercholesterolaemia in middle-aged males reduces CHD incidence, mostly that of non-fatal myocardial infarction. But there are many unresolved questions which should lead to a selective and moderate approach to the management of hypercholesterolaemia. These include lack of the exact knowledge of how raised cholesterol levels lead to atheroma; equivocal evidence of whether reduction of hypercholesterolaemia causes regression of atheroma; uncertainty about how far cholesterol levels can safely be reduced and whether the cost-benefit always justifies action; the fact that reduction of hypercholesterolaemia does not reduce total mortality and may increase non-cardiac mortality; and insufficient evidence as to whether the same policies for middle-aged men should be adopted for woman, the elderly and adolescents.
Oliver
M F
MF
Wynn Institute for Metabolic Research London, U. K.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002784:Cholesterol / Q000097:blood*; D003327:Coronary Disease / Q000097:blood / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate
D002784:Cholesterol