Potential effect on coronary-heart-disease morbidity of lowering the blood-cholesterol

As a practical aid to physicians and patients facing the decision whether or not to embark upon a life-long lipid-lowering regimen in the hope of preventing coronary heart-disease, estimates have been made of the potential benefits to be gained from lowering the plasma-cholesterol over a period of 20 years. The estimates have been derived from analyses of experiences in the Framingham population study. The results suggest that if 100 men who are non-smokers, with normal blood-pressure and electrocardiogram, lower their plasma-cholesterol from 310 to 260 mg. per 100 ml. starting at 35 years of age, 6 could potentially benefit by avoiding a coronary incident, 94 would be likely to follow the regimen without apparent benefit, and 8 of these would have an attack within 20 years despite adherence to the regimen. The potential benefit is less for women and for those who start the regimen at an older age. It is greater if cholesterol is lowered further and if other risk factors are present: for instance, 29 of 100 men starting at age 35 who are ciagrette smokers with moderate hypertension and left-ventricular hypertrophy and who reduce their plasma-cholesterol concentration from 310 to 210 mg. per 100 ml. would benefit.