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Lipoproteins and Atherogenesis Current Concepts

Daniel Steinberg, MD, PhD; Joseph L. Witztum, MD
JAMA. 1990;264(23):3047-3052. doi:10.1001/jama.1990.03450230083034.
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TODAY there is no longer any doubt about the causative relationship between hypercholesterolemia and premature atherosclerosis. The National Institutes of Health Consensus Conference on Lowering Blood Cholesterol Levels1 and the National Cholesterol Education Program that grew out of it2 were the culmination of many years of experimental and clinical research, including, importantly, a number of positive intervention trials that brought to a close the so-called Cholesterol Controversy,3 ie, the controversy as to the importance of hypercholesterolemia as a causative factor in coronary heart disease. Intensive lipid-lowering regimens have been shown not only to slow the progression of coronary atherosclerosis and reduce the risk of coronary events,4 but even in some cases to lead to absolute regression.5 Best medical practice now calls for appropriate treatment of hypercholesterolemia, and detailed guidelines for treating it are available.2,6

If we are, then, committed in any case to such


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