Assessing the benefits of lipid-lowering therapy.
In recent years, a substantial body of evidence has emerged to support the use of lipid-lowering therapy in the prevention of coronary artery disease, and many physician groups have endorsed the management of dyslipidemia in at-risk patients. An important consideration in such endorsements has been the issue of the safety of lipid intervention; many early primary- and secondary-prevention studies reported either no reduction in all-cause mortality rates or an increase in non-coronary artery disease mortality rates in treated patients. These observations raised serious concerns about the safety of such therapy. However, 2 landmark studies, the Scandinavian Simvastatin Survival Study (4S) and the West of Scotland Coronary Prevention Study (WOSCOPS), have contributed greatly to alleviating these concerns. In this article, a review of the epidemiologic evidence supporting the use of lipid modification will be presented, including important trials and meta-analyses, and the cost-effectiveness of lipid-modifying treatment will be discussed.
Joan and Sanford I. Weill Medical College of Cornell University, New York, New York 10021, USA.
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D002423:Cause of Death; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D003362:Cost-Benefit Analysis; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D000960:Hypolipidemic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D016896:Treatment Outcome
D000960:Hypolipidemic Agents