This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Frye, R. L. Search for Related Content PubMed PubMed Citation Articles by Frye, R. L.

(Circulation. 1997;95:306-307.)
© 1997 American Heart Association, Inc.

Articles

Clinical Reality of Lowering Total and LDL Cholesterol

Robert L. Frye, MD

the Mayo Clinic, Rochester, Minn.

Correspondence to Robert L. Frye, MD, Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905.

Key Words: Editorials • cholesterol • coronary disease

	Introduction

 
I recall first learning of the importance of cholesterol from the work of Dr Ancel Keys, based on his landmark epidemiological studies subsequently identified as the Seven Countries Study.¹ These population-based studies, in my own mind years ago, provided a general reference for judging the prevalence of coronary artery disease while providing a marker for risk of coronary artery disease over the long term. Most practitioners did not think of potential benefits to individual patients based on any short-term lowering of cholesterol levels, and treatment options were limited until the introduction of gemfibrozil and the statin drugs. The article by Andrews and colleagues² in this issue of Circulation reflects how dramatically our understanding has changed regarding the consequences of elevated total and LDL cholesterol levels and the opportunities to intervene with effective treatment strategies. In this study, selected patients with documented coronary artery disease associated with myocardial ischemia on ambulatory ECG monitoring were randomized to an American Heart Association step 1 diet plus lovastatin or the diet plus a placebo. Four to 6 months after randomization, lower mean total and LDL cholesterol levels were found in those randomized to lovastatin therapy. The 25% reduction in LDL in the lovastatin group was associated with a "highly significant" reduction in myocardial ischemia compared with the control group, based on quantification of myocardial ischemia by 24-hour ECG monitoring. The authors appropriately conclude that "cholesterol lowering with lovastatin appears to be effective in eliminating myocardial ischemia during daily life in a significant proportion of . . . [Full Text of this Article]

This article has been cited by other articles:

				P. Di Napoli and P. A. Barsotti Does 3-Hydroxy-3-methylglutaryl Coenzyme A Reductase Inhibitor Therapy Exert a Direct Anti-Ischemic Effect? Circulation, March 10, 1998; 97(9): 937 - 937. [Full Text]

				M. Gheorghiade and R. O. Bonow Chronic Heart Failure in the United States : A Manifestation of Coronary Artery Disease Circulation, January 27, 1998; 97(3): 282 - 289. [Full Text] [PDF]