RT Journal
A1 LaRosa JC
T1 STatins and risk of coronary heart disease—reply
JF JAMA
JO JAMA
YR 2000
FD June 14
VO 283
IS 22
SP 2935
OP 2935
DO 10.1001/jama.283.22.2931
UL http://dx.doi.org/10.1001/jama.283.22.2931
AB 
In Reply: Dr Clemenson raises the important
issue of primary vs secondary prevention. In our meta-analysis, which included
2 primary prevention trials with 13,200 participants and 3 secondary prevention
trials with 17,617 participants, statin drug treatment was associated with
a 34% proportional risk reduction (P<.001) in
major coronary events in the primary prevention trials and a 30% proportional
risk reduction (P<.001) in the secondary prevention
trials. Because of the homogeneity of proportional risk reduction in primary
and secondary prevention trials, results from individual trials were pooled
to provide more accurate and precise estimates. Our analysis indicated that
the proportional risk reduction of major coronary events associated with statin
drug treatment was similar in men (27%) and women (31%) and in participants
who were aged 65 years or older (23%) and those who were younger than 65 years
(31%). These findings strongly suggest that cholesterol lowering by statins
is effective for the primary prevention of coronary disease in both men and
women regardless of age.