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Hallvard Holdaas, Statin therapy for prevention of coronary artery disease. The earlier the better or the longer the better?, European Heart Journal, Volume 29, Issue 4, February 2008, Pages 425–426, https://doi.org/10.1093/eurheartj/ehm628
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Cholesterol lowering with statin therapy has been shown to reduce cardiovascular events in a variety of patient categories, ranging from patients with established cardiovascular disease to high-risk individuals with no previous history.1 The degree of benefit relates primarily to a patient's absolute risk of cardiovascular events and to the absolute reduction in low-density lipoprotein (LDL)-cholesterol. The optimal intensity of lipid-lowering therapy has been the focus of recent clinical trials, with growing support in the cardiovascular community for the concept of ‘the lower the better’ for LDL-cholesterol. As a result, the target for LDL-cholesterol has been adjusted for patients at moderate or high risk of cardiovascular events.2 Prolonged statin treatment with a significant reduction in LDL-cholesterol has also been strongly recommended.1 Sever and colleagues have presented the results of a 2-year extension of the Anglo-Scandinavian Cardiac Outcomes Trial lipid-lowering arm (ASCOT-LLA Extension).3
In the initial ASCOT trial, the blood pressure-lowering arm (ASCOT-BPLA) compared the effect of two different antihypertensive regimens on cardiovascular outcomes. ASCOT-LLA was a double-blind, placebo-controlled trial of atorvastatin 10 mg/day in patients enrolled in ASCOT-BPLA who had total cholesterol ≤6.5 mmol/L.