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COMMENTS & OPINIONS
The Role of Statins in Primary Prevention of Cardiovascular Disease
Klaus Eichler, MD, MPH;
Milo A. Puhan, MD, PhD;
Lucas M. Bachmann, MD, PhD
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Guidance on statin provision in patients without cardiovascular disease is of great practical importance. In recent years, several publications emerged showing conflicting results. The systematic review by Thavendiranathan et al1 is timely and covers a relevant issue but not without limitations. We have 3 observations.
First, this review enrolled moderate- and high-risk patients (average extrapolated 10-year coronary risk, 13%) despite the fact that greater than 80% of the US population who are free of cardiovascular disease do not fall into this risk category.2 No direct conclusions of the effects in this large group can therefore be made. Second, it is unclear how the authors reached the conclusion that "reductions in the risk of major coronary events from statin therapy were significantly associated with greater absolute baseline coronary artery disease risk."1(p2310) We were unable to reproduce this . . . [Full Text of this Article]
AUTHOR INFORMATION
RELATED LETTER
The Role of Statins in Primary Prevention of Cardiovascular Disease—Reply
Paaladinesh Thavendiranathan, Akshay Bagai, M. Alan Brookhart, and Niteesh K. Choudhry
Arch Intern Med. 2007;167(10):1100-1101.
EXTRACT
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Primary Prevention of Cardiovascular Diseases With Statin Therapy: A Meta-analysis of Randomized Controlled Trials
Paaladinesh Thavendiranathan, Akshay Bagai, M. Alan Brookhart, and Niteesh K. Choudhry
Arch Intern Med. 2006;166(21):2307-2313.
ABSTRACT
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Major Outcomes in Moderately Hypercholesterolemic, Hypertensive Patients Randomized to Pravastatin vs Usual Care: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)
The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group
JAMA. 2002;288(23):2998-3007.
ABSTRACT
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