statins top the list of cholesterol lowerers

From: Doug Skrecky (
Date: Tue May 09 2000 - 13:41:58 MDT

  Bucher HC. Griffith LE. Guyatt GH.
  Medizinsche Universitats-Poliklinik, Kantonsspital Basel, Basel,
  Systematic review on the
  risk and benefit of different
  cholesterol-lowering interventions.
  Arteriosclerosis, Thrombosis & Vascular Biology. 19(2):187-95, 1999 Feb.
  Meta-analyses have investigated the efficacy of
  cholesterol-lowering interventions in relation to the
  underlying risk of coronary heart disease and
  the extent and duration of cholesterol reduction. We
  systematically reviewed
  the efficacy of antilipidemic interventions on major
  mortality outcomes in relation to drug classes. We searched MEDLINE and
  EMBASE from 1966 through October 1996 for randomized, controlled trials of
  any cholesterol-lowering interventions reporting mortality data. We included
  59 trials involving 85 431 participants in the intervention
  and 87 729 participants in the control groups. We pooled
  these trials into 7 pharmacological categories of
  cholesterol-lowering interventions: statins (13 trials), fibrates (12
  trials), resins (8 trials), hormones (8 trials), niacin acid (2 trials), n-3
  fatty acids (3 trials), and dietary interventions (16 trials). Of
  the cholesterol-lowering interventions, only statins showed
  a large and statistically significant reduction in mortality from coronary
  heart disease (risk ratio, 0.66; 95% confidence interval
  [CI], 0.54 to 0. 79) and from all causes (risk ratio, 0.75;
  95% CI, 0.65 to 0.86). For both all-cause and cardiovascular mortality,
  the difference between statins and the
  combined estimate of the other classes of
  agents was unlikely to be due to chance (P<0.02 for both comparisons).
  Meta-regression analysis demonstrated that variability in results across
  trials could be largely explained on the basis of
  differences in the magnitude of cholesterol reduction.
  Statins have the largest effect on the
  reduction of cardiovascular and all-cause mortality, and this result
  recommends their use in preference to other
  antilipidemic agents. The greater effect of statins is
  likely due to the larger reduction in cholesterol.

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