Rationale for Intervention re: CHD

Discussion in 'Health and medical' started by listener, Mar 3, 2004.

  1. listener

    listener Guest

    A lengthy report that touches a lot of bases concerning CHD, markers for such and various
    interventions, both primary and secondary.


    "Effectiveness of LDL-lowering drugs in primary prevention Clinical trials of cholesterol-lowering
    drugs support the efficacy of clinical primary prevention in higher risk persons. In the era before
    statin drugs, several primary prevention trials of cholesterol lowering were carried out with drug
    intervention.44 Landmark trials among these were the World Health Organization clofibrate trial,149
    the Helsinki Heart Study gemfibrozil trial,139,411,412 and the Lipid Research Clinics cholestyramine
    trial.12,13 All of these trials of lipid-lowering therapy reduced major coronary events. However,
    they were underpowered to address the issue of total mortality; hence, in the minds of many, the
    benefits of lipid modification in primary prevention remained uncertain.413-415 The availability of
    more efficacious cholesterol-lowering drugs (statins) made it possible to definitively test whether
    LDL lowering would reduce CHD risk. Two major primary prevention trials with statins were the West
    of Scotland Coronary Prevention Study (WOSCOPS)416 and the Air Force/Texas Coronary Atherosclerosis
    Prevention Study (AFCAPS/TexCAPS)207. Their results are summarized in Table II.7-1. In both trials,
    statin therapy significantly reduced relative risk for major coronary events. WOSCOPS also showed a
    very strong trend towards a reduction in total mortality. In AFCAPS/TexCAPS, the numbers of deaths
    in both placebo and treatment groups were so small that no conclusions could be drawn about effects
    of cholesterol-lowering therapy on total mortality; however, no significant adverse effects of
    statin therapy were detected. "