Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials - PubMed (original) (raw)

Meta-Analysis

Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials

M F Muldoon et al. BMJ. 1990.

Abstract

Objective: To determine the effects of lowering cholesterol concentrations on total and cause specific mortality in randomised primary prevention trials.

Design: Qualitative (meta-analytic) evaluation of total mortality from coronary heart disease, cancer, and causes not related to illness in six primary prevention trials of cholesterol reduction (mean duration of treatment 4.8 years).

Patients: 24,847 Male participants; mean age 47.5 years.

Main outcome measures: Total and cause specific mortalities.

Results: Follow up periods totalled 119,000 person years, during which 1147 deaths occurred. Mortality from coronary heart disease tended to be lower in men receiving interventions to reduce cholesterol concentrations compared with mortality in control subjects (p = 0.06), although total mortality was not affected by treatment. No consistent relation was found between reduction of cholesterol concentrations and mortality from cancer, but there was a significant increase in deaths not related to illness (deaths from accidents, suicide, or violence) in groups receiving treatment to lower cholesterol concentrations relative to controls (p = 0.004). When drug trials were analysed separately the treatment was found to reduce mortality from coronary heart disease significantly (p = 0.04).

Conclusions: The association between reduction of cholesterol concentrations and deaths not related to illness warrants further investigation. Additionally, the failure of cholesterol lowering to affect overall survival justifies a more cautious appraisal of the probable benefits of reducing cholesterol concentrations in the general population.

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Comment in

• Low serum cholesterol and violent death.
  Benton D, Fordy J. Benton D, et al. BMJ. 1992 Sep 26;305(6856):772-3. doi: 10.1136/bmj.305.6856.772-c. BMJ. 1992. PMID: 1422347 Free PMC article. No abstract available.
• Lowering cholesterol concentrations and mortality.
  [No authors listed] [No authors listed] BMJ. 1990 Oct 6;301(6755):814-5. doi: 10.1136/bmj.301.6755.814-a. BMJ. 1990. PMID: 2224274 Free PMC article. No abstract available.
• Lowering cholesterol concentrations and mortality.
  [No authors listed] [No authors listed] BMJ. 1990 Sep 15;301(6751):552-5. doi: 10.1136/bmj.301.6751.552-a. BMJ. 1990. PMID: 2271045 Free PMC article. No abstract available.

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References

1. 1. Br J Psychiatry Suppl. 1989 Dec;(8):52-62 - PubMed
2. 1. Biol Psychiatry. 1984 Mar;19(3):435-9 - PubMed
3. 1. Arch Gen Psychiatry. 1989 Jul;46(7):604-6 - PubMed
4. 1. Control Clin Trials. 1986 Sep;7(3):177-88 - PubMed
5. 1. Biochem Pharmacol. 1985 Apr 1;34(7):1120-1 - PubMed

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