[LDL cholesterol in normal range. The lower the better? Implications of the GREACE study]

The higher an individual patient's risk, the greater the clinical effect of lipid lowering drug therapy. According to present guidelines, therapeutic decisions should be guided by the patient's overall risk. This depends not only on the LDL cholesterol, but also on the number and degree of other risk factors. This paper will show that LDL cholesterol before treatment determines the clinical efficacy of a statin: for instance, using a statin to lower the LDL cholesterol by one third gives a greater risk reduction the higher the baseline value. For a given baseline value, greater risk reduction results from a larger reduction in LDL cholesterol. LDL cholesterol measurement is thus essential before and on treatment.