[Results of prevention trials by intervention with lipids]

When only statistically comparable studies are taken into account, there are three primary prevention and eight secondary prevention studies. In 9 out these 11 studies the calculated decrease in the incidence of coronary disease are in favour of a beneficial effect of the lipid-lowering treatment. Some studies suggest that femoral atherosclerosis is receding and that coronary atherosclerosis is stable or progresses more slowly, but this always provided the plasma lipids are significantly and durably reduced. Subjects at high cardiovascular risk, therefore, must be treated, but one should now proceed even further, since the decrease of total cholesterol in the general population is paralleled by a decrease of coronary disease. This is in keeping with the results of extensive epidemiological surveys (notably the Framingham survey) which show that the lower the total cholesterol level the brighter the cardiovascular prognosis.