Cholesterol lowering and the reduction of CHD incidence and total mortality: results from a meta-analysis of randomized trials.

This editorial reports on a meta-analysis done on cholesterol-lowering trials. Coronary heart disease incidence is reported for 16 trials and total mortality for 19 trials. The cholesterol benefit ratio, i.e., the percent risk reduction divided by the percent cholesterol reduction, was analyzed in terms of total vs. potential modifying factors. For coronary heart disease the benefit ratio was 2.8 (95% CL: 1.5, 4.2), and for total mortality it was 1.2 (95% CL: -0.1, 2.3). Cholesterol reduction had to be at least 8-9% to outweigh the negative impact of treatment on total mortality.