Papers

By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease?

Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, St Bartholomew's Medical College, London, EC1M 6BQ Correspondence to: Dr Law.

Abstract

Objective : To estimate by how much and how quickly a given reduction in serum cholesterol concentration will reduce the risk of ischaemic heart disease.
Design : Data on the incidence of ischaemic heart disease and serum cholesterol concentration were analysed from 10 prospective (cohort) studies, three international studies in different communities, and 28 randomised controlled trials (with mortality data analysed according to allocated treatment to ensure the avoidance of bias). Main outcome measure - Decrease in incidence of ischaemic heart disease or mortality for a 0.6 mmol/l (about 10%) decrease in serum cholesterol concentration.
Results : For men results from the cohort studies showed that a decrease of serum cholesterol concentration of 0.6 mmol/l (about 10%) was associated with a decrease in incidence of ischaemic heart disease of 54% at age 40 years, 39% at age 50, 27% at 60, 20% at 70, and 19% at 80. The combined estimate from the three international studies (for ages 55-64 years) was 38% (95% confidence interval 33% to 42% ), somewhat greater than the cohort study estimate of 27%. The reductions in incidence of ischaemic heart disease in the randomised trials (for ages 55-64 years) were 7% (0 to 14%) in the first two years, 22% (15% to 28%) from 2.1-5 years, and 25% (15% to 35%) after five years, the last estimate being lose to the estimate of 27% for the long term reduction from the cohort studies. The data for women are limited but indicate a similar effect. Conclusions - The results from the cohort studies, international comparisons, and clinical trials are remarkably consistent. The cohort studies, based on half a million men and 18 000 ischaemic heart disease events, estimate that a long term reduction in serum cholesterol concentration of 0.6 mmol/l (10%), which can be achieved by moderate dietary change,lowers the risk of ischaemic heart disease by 50% at age 40, falling to 20% at age 70. The randomised trials, based on 45 000 men and 4000 ischaemic heart disease events show that the full effect of the reduction in risk is achieved by five years.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Effects of statins in patients with chronic kidney disease: meta-analysis and meta-regression of randomised controlled trials

Giovanni F M Strippoli, Sankar D Navaneethan, David W Johnson, Vlado Perkovic, Fabio Pellegrini, Antonio Nicolucci, and Jonathan C Craig
BMJ 2008 336: 645-651. [Abstract] [Full Text] [PDF]

Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: meta-analysis of randomised controlled trials

João Costa, Margarida Borges, Cláudio David, and António Vaz Carneiro
BMJ 2006 332: 1115-1124. [Abstract] [Full Text] [PDF]

Optimal age for starting lipid lowering treatment

William G Simpson, Patrick Twomey, Tom Marshall, Peter R Jackson, Erica J Wallis, Lawrence E Ramsay, Patrick Vallance, Aroon D Hingorani, and Silvia Ulrich
BMJ 2000 321: 637. [Extract] [Full Text]

This article has been cited by other articles:

• Klingberg, S., Ellegard, L., Johansson, I., Hallmans, G., Weinehall, L., Andersson, H., Winkvist, A. (2008). Inverse relation between dietary intake of naturally occurring plant sterols and serum cholesterol in northern Sweden. Am. J. Clin. Nutr. 87: 993-1001 [Abstract] [Full text]  
• Griel, A. E., Cao, Y., Bagshaw, D. D., Cifelli, A. M., Holub, B., Kris-Etherton, P. M. (2008). A Macadamia Nut-Rich Diet Reduces Total and LDL-Cholesterol in Mildly Hypercholesterolemic Men and Women. J. Nutr. 138: 761-767 [Abstract] [Full text]  
• Strippoli, G. F M, Navaneethan, S. D, Johnson, D. W, Perkovic, V., Pellegrini, F., Nicolucci, A., Craig, J. C (2008). Effects of statins in patients with chronic kidney disease: meta-analysis and meta-regression of randomised controlled trials. BMJ 336: 645-651 [Abstract] [Full text]  
• Grundy, S. M. (2008). A changing paradigm for prevention of cardiovascular disease: emergence of the metabolic syndrome as a multiplex risk factor. Eur Heart J Suppl 10: B16-B23 [Abstract] [Full text]  
• Hardoon, S. L., Whincup, P. H., Lennon, L. T., Wannamethee, S. G., Capewell, S., Morris, R. W. (2008). How Much of the Recent Decline in the Incidence of Myocardial Infarction in British Men Can Be Explained by Changes in Cardiovascular Risk Factors?: Evidence From a Prospective Population-Based Study. Circulation 117: 598-604 [Abstract] [Full text]  
• Grundy, S. M. (2008). Promise of Low-Density Lipoprotein-Lowering Therapy for Primary and Secondary Prevention. Circulation 117: 569-573 [Full text]  
• Konhilas, J. P., Leinwand, L. A. (2007). The Effects of Biological Sex and Diet on the Development of Heart Failure. Circulation 116: 2747-2759 [Full text]  
• Gardner, C. D., Messina, M., Kiazand, A., Morris, J. L., Franke, A. A. (2007). Effect of Two Types of Soy Milk and Dairy Milk on Plasma Lipids in Hypercholesterolemic Adults: A Randomized Trial. J. Am. Coll. Nutr. 26: 669-677 [Abstract] [Full text]  
• Marschner, I. C., Simes, R. J., Keech, A. (2007). Biases in the Identification of Risk Factor Thresholds and J-Curves. Am J Epidemiol 166: 824-831 [Abstract] [Full text]  
• Mytton, O., Gray, A., Rayner, M., Rutter, H. (2007). Could targeted food taxes improve health?. J. Epidemiol. Community Health 61: 689-694 [Abstract] [Full text]  
• Ford, E. S., Ajani, U. A., Croft, J. B., Critchley, J. A., Labarthe, D. R., Kottke, T. E., Giles, W. H., Capewell, S. (2007). Explaining the Decrease in U.S. Deaths from Coronary Disease, 1980-2000. NEJM 356: 2388-2398 [Abstract] [Full text]  
• Kabir, Z., Bennett, K., Shelley, E., Unal, B., Critchley, J., Feely, J., Capewell, S. (2007). Life-years-gained from population risk factor changes and modern cardiology treatments in Ireland. Eur J Public Health 17: 193-198 [Abstract] [Full text]  
• Boshuizen, H. C., Lanti, M., Menotti, A., Moschandreas, J., Tolonen, H., Nissinen, A., Nedeljkovic, S., Kafatos, A., Kromhout, D. (2007). Effects of Past and Recent Blood Pressure and Cholesterol Level on Coronary Heart Disease and Stroke Mortality, Accounting for Measurement Error. Am J Epidemiol 165: 398-409 [Abstract] [Full text]  
• Penning-van Beest, F. J.A., Termorshuizen, F., Goettsch, W. G., Klungel, O. H., Kastelein, J. J.P., Herings, R. M.C. (2007). Adherence to evidence-based statin guidelines reduces the risk of hospitalizations for acute myocardial infarction by 40%: a cohort study. Eur Heart J 28: 154-159 [Abstract] [Full text]  
• Rippe, J. M., Angelopoulos, T. J., Zukley, L. (2007). The Rationale for Intervention to Reduce the Risk of Coronary Heart Disease. AMERICAN JOURNAL OF LIFESTYLE MEDICINE 1: 10-19 [Abstract]  
• Shor, R., Wainstein, J., Oz, D., Boaz, M., Matas, Z., Fux, A., Halabe, A. (2007). Low Serum LDL Cholesterol Levels and the Risk of Fever, Sepsis, and Malignancy. Annals of Clinical & Laboratory Science 37: 343-348 [Abstract] [Full text]  
• Moy, F., Sallam, A. A. B., Wong, M. (2006). The results of a worksite health promotion programme in Kuala Lumpur, Malaysia. HEALTH PROMOT INT 21: 301-310 [Abstract] [Full text]  
• Hayward, R. A., Hofer, T. P., Vijan, S. (2006). Narrative review: lack of evidence for recommended low-density lipoprotein treatment targets: a solvable problem.. ANN INTERN MED 145: 520-530 [Abstract] [Full text]  
• Rice, T. W., Lumsden, A. B. (2006). Optimal Medical Management of Peripheral Arterial Disease. VASC ENDOVASCULAR SURG 40: 312-327 [Abstract]  
• Costa, J., Borges, M., David, C., Vaz Carneiro, A. (2006). Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: meta-analysis of randomised controlled trials. BMJ 332: 1115-1124 [Abstract] [Full text]  
• Bennett, K., Kabir, Z., Unal, B., Shelley, E., Critchley, J., Perry, I., Feely, J., Capewell, S. (2006). Explaining the recent decrease in coronary heart disease mortality rates in Ireland, 1985-2000.. J. Epidemiol. Community Health 60: 322-327 [Abstract] [Full text]  
• Wiviott, S. D., de Lemos, J. A., Cannon, C. P., Blazing, M., Murphy, S. A., McCabe, C. H., Califf, R., Braunwald, E. (2006). A Tale of Two Trials: A Comparison of the Post-Acute Coronary Syndrome Lipid-Lowering Trials A to Z and PROVE IT-TIMI 22. Circulation 113: 1406-1414 [Abstract] [Full text]  
• Raitakari, O. T., Ronnemaa, T., Jarvisalo, M. J., Kaitosaari, T., Volanen, I., Kallio, K., Lagstrom, H., Jokinen, E., Niinikoski, H., Viikari, J. S.A., Simell, O. (2005). Endothelial Function in Healthy 11-Year-Old Children After Dietary Intervention With Onset in Infancy: The Special Turku Coronary Risk Factor Intervention Project for Children (STRIP). Circulation 112: 3786-3794 [Abstract] [Full text]  
• Prepared by: British Cardiac Society, British Hype, (2005). JBS 2: Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice. Heart 91: v1-v52 [Full text]  
• Lewington, S., Clarke, R. (2005). Combined Effects of Systolic Blood Pressure and Total Cholesterol on Cardiovascular Disease Risk. Circulation 112: 3373-3374 [Full text]  
• Pedersen, T. R., Faergeman, O., Kastelein, J. J. P., Olsson, A. G., Tikkanen, M. J., Holme, I., Larsen, M. L., Bendiksen, F. S., Lindahl, C., Szarek, M., Tsai, J., for the Incremental Decrease in End Points Through, (2005). High-Dose Atorvastatin vs Usual-Dose Simvastatin for Secondary Prevention After Myocardial Infarction: The IDEAL Study: A Randomized Controlled Trial. JAMA 294: 2437-2445 [Abstract] [Full text]  
• Robinson, J. G., Smith, B., Maheshwari, N., Schrott, H. (2005). Pleiotropic Effects of Statins: Benefit Beyond Cholesterol Reduction?: A Meta-Regression Analysis. J Am Coll Cardiol 46: 1855-1862 [Abstract] [Full text]  
• Vincent-Baudry, S., Defoort, C., Gerber, M., Bernard, M.-C., Verger, P., Helal, O., Portugal, H., Planells, R., Grolier, P., Amiot-Carlin, M.-J., Vague, P., Lairon, D. (2005). The Medi-RIVAGE study: reduction of cardiovascular disease risk factors after a 3-mo intervention with a Mediterranean-type diet or a low-fat diet. Am. J. Clin. Nutr. 82: 964-971 [Abstract] [Full text]  
• Laatikainen, T., Critchley, J., Vartiainen, E., Salomaa, V., Ketonen, M., Capewell, S. (2005). Explaining the Decline in Coronary Heart Disease Mortality in Finland between 1982 and 1997. Am J Epidemiol 162: 764-773 [Abstract] [Full text]  
• O'Donovan, G., Owen, A., Bird, S. R., Kearney, E. M., Nevill, A. M., Jones, D. W., Woolf-May, K. (2005). Changes in cardiorespiratory fitness and coronary heart disease risk factors following 24 wk of moderate- or high-intensity exercise of equal energy cost. J. Appl. Physiol. 98: 1619-1625 [Abstract] [Full text]  
• Dodin, S., Lemay, A., Jacques, H., Legare, F., Forest, J.-C., Masse, B. (2005). The Effects of Flaxseed Dietary Supplement on Lipid Profile, Bone Mineral Density, and Symptoms in Menopausal Women: A Randomized, Double-Blind, Wheat Germ Placebo-Controlled Clinical Trial. J. Clin. Endocrinol. Metab. 90: 1390-1397 [Abstract] [Full text]  
• Unal, B., Critchley, J. A., Fidan, D., Capewell, S. (2005). Life-Years Gained From Modern Cardiological Treatments and Population Risk Factor Changes in England and Wales, 1981-2000. Am. J. Public Health 95: 103-108 [Abstract] [Full text]  
• Franco, O. H, Bonneux, L., de Laet, C., Peeters, A., Steyerberg, E. W, Mackenbach, J. P (2004). The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75%. BMJ 329: 1447-1450 [Abstract] [Full text]  
• Karp, I., Abrahamowicz, M., Bartlett, G., Pilote, L. (2004). Updated Risk Factor Values and the Ability of the Multivariable Risk Score to Predict Coronary Heart Disease. Am J Epidemiol 160: 707-716 [Abstract] [Full text]  
• Critchley, J., Liu, J., Zhao, D., Wei, W., Capewell, S. (2004). Explaining the Increase in Coronary Heart Disease Mortality in Beijing Between 1984 and 1999. Circulation 110: 1236-1244 [Abstract] [Full text]  
• Grundy, S. M., Cleeman, J. I., Bairey Merz, C. N., Brewer, H. B. Jr, Clark, L. T., Hunninghake, D. B., Pasternak, R. C., Smith, S. C. Jr, Stone, N. J., Coordinating Committee of the National Cholesterol, (2004). Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. J Am Coll Cardiol 44: 720-732 [Abstract] [Full text]  
• Clifton, P. M., Noakes, M., Ross, D., Fassoulakis, A., Cehun, M., Nestel, P. (2004). High dietary intake of phytosterol esters decreases carotenoids and increases plasma plant sterol levels with no additional cholesterol lowering. J. Lipid Res. 45: 1493-1499 [Abstract] [Full text]  
• Grundy, S. M., Cleeman, J. I., Merz, C. N. B., Brewer, H. B. Jr, Clark, L. T., Hunninghake, D. B., Pasternak, R. C., Smith, S. C. Jr, Stone, N. J., for the Coordinating Committee of the National Cho, , Endorsed by the National Heart, Lung, and Blood In, (2004). Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Arterioscler. Thromb. Vasc. Bio. 24: e149-e161 [Abstract] [Full text]  
• Grundy, S. M., Cleeman, J. I., Merz, C. N. B., Brewer, H. B. Jr, Clark, L. T., Hunninghake, D. B., Pasternak, R. C., Smith, S. C. Jr, Stone, N. J., for the Coordinating Committee of the National Cho, , Endorsed by the National Heart, Lung, and Blood In, (2004). Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation 110: 227-239 [Abstract] [Full text]  
• Norris, S. L., Zhang, X., Avenell, A., Gregg, E., Schmid, C. H., Kim, C., Lau, J. (2004). Efficacy of Pharmacotherapy for Weight Loss in Adults With Type 2 Diabetes Mellitus: A Meta-analysis. Arch Intern Med 164: 1395-1404 [Abstract] [Full text]  
• Feigin, V. L., Rodgers, A. (2004). Editorial Comment--Ethnic Disparities in Risk Factors for Stroke: What Are the Implications?. Stroke 35: 1568-1569 [Full text]  
• McElduff, P, Lyratzopoulos, G, Edwards, R, Heller, R F, Shekelle, P, Roland, M (2004). Will changes in primary care improve health outcomes? Modelling the impact of financial incentives introduced to improve quality of care in the UK. Qual Saf Health Care 13: 191-197 [Abstract] [Full text]  
• O'Loughlin, J., Lauzon, B., Paradis, G., Hanley, J., Levy, E., Delvin, E., Lambert, M. (2004). Usefulness of the American Academy of Pediatrics Recommendations for Identifying Youths With Hypercholesterolemia. Pediatrics 113: 1723-1727 [Abstract] [Full text]  
• Wald, D. S. (2004). Vitamin Supplementation and Risk of Stroke. JAMA 291: 2191-2191 [Full text]  
• Ho, P. M., Masoudi, F. A., Peterson, E. D., Grunwald, G. K., Sales, A. E., Hammermeister, K. E., Rumsfeld, J. S. (2004). Cardiology management improves secondary prevention measures among patients with coronary artery disease. J Am Coll Cardiol 43: 1517-1523 [Abstract] [Full text]  
• Monzani, F., Caraccio, N., Kozakowa, M., Dardano, A., Vittone, F., Virdis, A., Taddei, S., Palombo, C., Ferrannini, E. (2004). Effect of Levothyroxine Replacement on Lipid Profile and Intima-Media Thickness in Subclinical Hypothyroidism: A Double-Blind, Placebo- Controlled Study. J. Clin. Endocrinol. Metab. 89: 2099-2106 [Abstract] [Full text]  
• Unal, B., Critchley, J. A., Capewell, S. (2004). Explaining the Decline in Coronary Heart Disease Mortality in England and Wales Between 1981 and 2000. Circulation 109: 1101-1107 [Abstract] [Full text]  
• Wald, N. J, Morris, J. K (2003). Teleoanalysis: combining data from different types of study. BMJ 327: 616-618 [Full text]  
• Ganotakis, E. S., Mandalaki, K., Tampakaki, M., Malliaraki, N., Mandalakis, E., Vrentzos, G., Melissas, J., Castanas, E. (2003). Subclinical Hypothyroidism and Lipid Abnormalities in Older Women Attending a Vascular Disease Prevention Clinic: Effect of Thyroid Replacement Therapy. ANGIOLOGY 54: 569-576 [Abstract]  
• Asia Pacific Cohort Studies Collaboration, (2003). Cholesterol, coronary heart disease, and stroke in the Asia Pacific region. Int J Epidemiol 32: 563-572 [Abstract] [Full text]  
• West, J, Logan, R F A, Hill, P G, Lloyd, A, Lewis, S, Hubbard, R, Reader, R, Holmes, G K T, Khaw, K-T (2003). Seroprevalence, correlates, and characteristics of undetected coeliac disease in England. Gut 52: 960-965 [Abstract] [Full text]  
• Wald, N J, Law, M R (2003). A strategy to reduce cardiovascular disease by more than 80%. BMJ 326: 1419- [Abstract] [Full text]  
• Law, M R, Wald, N J, Rudnicka, A R (2003). Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ 326: 1423- [Abstract] [Full text]  
• Kwiterovich, P. O. Jr., Chen, S. C., Virgil, D. G., Schweitzer, A., Arnold, D. R., Kratz, L. E. (2003). Response of obligate heterozygotes for phytosterolemia to a low-fat diet and to a plant sterol ester dietary challenge. J. Lipid Res. 44: 1143-1155 [Abstract] [Full text]  
• Faergeman, O. (2003). Low-density lipoprotein cholesterol targets in 2003. Eur Heart J Suppl 5: D3-D7 [Abstract]  
• Owen, C. G., Whincup, P. H., Odoki, K., Gilg, J. A., Cook, D. G. (2003). Birth Weight and Blood Cholesterol Level: A Study in Adolescents and Systematic Review. Pediatrics 111: 1081-1089 [Abstract] [Full text]  
• Kitas, G. D., Erb, N. (2003). Tackling ischaemic heart disease in rheumatoid arthritis. Rheumatology (Oxford) 42: 607-613 [Full text]  
• Critchley, J A, Capewell, S (2003). Substantial potential for reductions in coronary heart disease mortality in the UK through changes in risk factor levels. J. Epidemiol. Community Health 57: 243-247 [Abstract] [Full text]  
• Feher, M. D (2003). Lipid lowering to delay the progression of coronary artery disease. Heart 89: 451-458 [Full text]  
• Budzynski, J., Klopocka, M., Swiatkowski, M., Pulkowski, G., Ziolkowski, M. (2003). LIPOPROTEIN(a) IN ALCOHOL-DEPENDENT MALE PATIENTS DURING A SIX-MONTH ABSTINENCE PERIOD. Alcohol Alcohol 38: 157-162 [Abstract] [Full text]  
• Nommsen-Rivers, L. (2003). The Long-Term Effects of Early Nutrition: The Role of Breastfeeding on Cholesterol Levels. J Hum Lact 19: 103-104  
• (2002). References. Circulation 106: 3373-3421 [Full text]  
• Di Napoli, P., Taccardi, A.A., Oliver, M., De Caterina, R. (2002). Statins and stroke: evidence for cholesterol-independent effects. Eur Heart J 23: 1908-1921  
• Beaglehole, R., Magnus, P. (2002). The search for new risk factors for coronary heart disease: occupational therapy for epidemiologists?. Int J Epidemiol 31: 1117-1122 [Abstract] [Full text]  
• Owen, C. G., Whincup, P. H., Odoki, K., Gilg, J. A., Cook, D. G. (2002). Infant Feeding and Blood Cholesterol: A Study in Adolescents and a Systematic Review. Pediatrics 110: 597-608 [Abstract] [Full text]  
• Law, M R, Wald, N J (2002). Risk factor thresholds: their existence under scrutiny. BMJ 324: 1570-1576 [Full text]  
• Grundy, S. M. (2002). Statin Therapy in Older Persons: Pertinent Issues. Arch Intern Med 162: 1329-1331 [Full text]  
• Caraccio, N., Ferrannini, E., Monzani, F. (2002). Lipoprotein Profile in Subclinical Hypothyroidism: Response to Levothyroxine Replacement, a Randomized Placebo-Controlled Study. J. Clin. Endocrinol. Metab. 87: 1533-1538 [Abstract] [Full text]  
• Simes, J, Furberg, C.D, Braunwald, E, Davis, B.R, Ford, I, Tonkin, A, Shepherd, J, for the Prosective Pravastatin Pooling project inv, (2002). Effects of pravastatin on mortality in patients with and without coronary heart disease across a broad range of cholesterol levels. The Prospective Pravastatin Pooling project. Eur Heart J 23: 207-215 [Abstract]  
• Lichtenstein, A. H., Ausman, L. M., Jalbert, S. M., Vilella-Bach, M., Jauhiainen, M., McGladdery, S., Erkkila, A. T., Ehnholm, C., Frohlich, J., Schaefer, E. J. (2002). Efficacy of a Therapeutic Lifestyle Change/Step 2 diet in moderately hypercholesterolemic middle-aged and elderly female and male subjects. J. Lipid Res. 43: 264-273 [Abstract] [Full text]  
• Critchley, J.A., Capewell, S. (2002). Why model coronary heart disease?. Eur Heart J 23: 110-116 [Full text]  
• Poppitt, S. D, Keogh, G. F, Prentice, A. M, Williams, D. E., Sonnemans, H. M., Valk, E. E., Robinson, E., Wareham, N. J (2002). Long-term effects of ad libitum low-fat, high-carbohydrate diets on body weight and serum lipids in overweight subjects with metabolic syndrome. Am. J. Clin. Nutr. 75: 11-20 [Abstract] [Full text]  
• Magnus, P., Beaglehole, R. (2001). The Real Contribution of the Major Risk Factors to the Coronary Epidemics: Time to End the "Only-50%" Myth. Arch Intern Med 161: 2657-2660 [Full text]  
• Marmot, M. (2001). Aetiology of coronary heart disease. BMJ 323: 1261-1262 [Full text]  
• Houterman, S, Verschuren, W., Oomen, C., Boersma-Cobbaert, C., Kromhout, D (2001). Trends in total and high density lipoprotein cholesterol and their determinants in The Netherlands between 1993 and 1997. Int J Epidemiol 30: 1063-1070 [Abstract] [Full text]  
• Maki, K. C, Davidson, M. H, Umporowicz, D. M, Schaefer, E. J, Dicklin, M. R, Ingram, K. A, Chen, S., McNamara, J. R, Gebhart, B. W, Ribaya-Mercado, J. D, Perrone, G., Robins, S. J, Franke, W. C (2001). Lipid responses to plant-sterol-enriched reduced-fat spreads incorporated into a National Cholesterol Education Program Step I diet. Am. J. Clin. Nutr. 74: 33-43 [Abstract] [Full text]  
• Yarzebski, J., Spencer, F., Goldberg, R. J., Lessard, D., Gore, J. M. (2001). Temporal Trends (1986-1997) in Cholesterol Level Assessment and Management Practices in Patients With Acute Myocardial Infarction: A Population-Based Perspective. Arch Intern Med 161: 1521-1528 [Abstract] [Full text]  
• van Hout, B.A., Simoons, M.L. (2001). Cost-effectiveness of HMG coenzyme reductase inhibitors. Whom to treat?. Eur Heart J 22: 751-761 [Abstract]  
• Bartley, M, Fitzpatrick, R, Firth, D, Marmot, M (2000). Social distribution of cardiovascular disease risk factors: change among men in England 1984-1993. J. Epidemiol. Community Health 54: 806-814 [Abstract] [Full text]  
• Law, M. (2000). Dietary fat and adult diseases and the implications for childhood nutrition: an epidemiologic approach. Am. J. Clin. Nutr. 72 : 1291S-1296S [Abstract] [Full text]  
• Simell, O., Niinikoski, H., Ronnemaa, T., Lapinleimu, H., Routi, T., Lagstrom, H., Salo, P., Jokinen, E., Viikari, J. (2000). Special Turku Coronary Risk Factor Intervention Project for Babies (STRIP). Am. J. Clin. Nutr. 72 : 1316S-1331S [Abstract] [Full text]  
• Rask-Nissila, L., Jokinen, E., Ronnemaa, T., Viikari, J., Tammi, A., Niinikoski, H., Seppanen, R., Tuominen, J., Simell, O. (2000). Prospective, Randomized, Infancy-Onset Trial of the Effects of a Low-Saturated-Fat, Low-Cholesterol Diet on Serum Lipids and Lipoproteins Before School Age : The Special Turku Coronary Risk Factor Intervention Project (STRIP). Circulation 102: 1477-1483 [Abstract] [Full text]  
• Capewell, S., Beaglehole, R., Seddon, M., McMurray, J. (2000). Explanation for the Decline in Coronary Heart Disease Mortality Rates in Auckland, New Zealand, Between 1982 and 1993. Circulation 102: 1511-1516 [Abstract] [Full text]  
• Simpson, W. G, Twomey, P., Marshall, T., Jackson, P. R, Wallis, E. J, Ramsay, L. E, Vallance, P., Hingorani, A. D, Ulrich, S. (2000). Optimal age for starting lipid lowering treatment. BMJ 321: 637-637 [Full text]  
• Rask-Nissila, L., Jokinen, E., Terho, P., Tammi, A., Lapinleimu, H., Ronnemaa, T., Viikari, J., Seppanen, R., Korhonen, T., Tuominen, J., Valimaki, I., Simell, O. (2000). Neurological Development of 5-Year-Old Children Receiving a Low-Saturated Fat, Low-Cholesterol Diet Since Infancy: A Randomized Controlled Trial. JAMA 284: 993-1000 [Abstract] [Full text]  
• Lindholm, L, Rosén, M (2000). What is the "golden standard" for assessing population-based interventions?---problems of dilution bias. J. Epidemiol. Community Health 54: 617-622 [Abstract] [Full text]  
• Grundy, S. M. (2000). Early Detection of High Cholesterol Levels in Young Adults. JAMA 284: 365-367 [Full text]  
• Neary, R., Ramachandran, S., Durrington, P N, Albert, D., Jeffries, D., Fowler, P B S (2000). Risk in cardiovascular disease. BMJ 321: 174-174 [Full text]  
• Grundy, S. M. (2000). Cholesterol-Lowering Therapy in Secondary Prevention: Remaining Issues. J. Clin. Endocrinol. Metab. 85: 2092-2098 [Full text]  
• Hunninghake, D. B., Maki, K. C., Kwiterovich, P. O. Jr, Davidson, M. H., Dicklin, M. R., Kafonek, S. D. (2000). Incorporation of Lean Red Meat into a National Cholesterol Education Program Step I Diet: A Long-Term, Randomized Clinical Trial in Free-Living Persons with Hypercholesterolemia. J. Am. Coll. Nutr. 19: 351-360 [Abstract] [Full text]  
• Ulrich, S., Hingorani, A. D, Martin, J., Vallance, P. (2000). What is the optimal age for starting lipid lowering treatment? A mathematical model. BMJ 320: 1134-1140 [Full text]  
• Leeson, C. P. M., Whincup, P. H., Cook, D. G., Mullen, M. J., Donald, A. E., Seymour, C. A., Deanfield, J. E. (2000). Cholesterol and Arterial Distensibility in the First Decade of Life : A Population-Based Study. Circulation 101: 1533-1538 [Abstract] [Full text]  
• Nauck, M., Graziani, M. S., Bruton, D., Cobbaert, C., Cole, T. G., Lefevre, F., Riesen, W., Bachorik, P. S., Rifai, N. (2000). Analytical and Clinical Performance of a Detergent-based Homogeneous LDL-Cholesterol Assay: A Multicenter Evaluation. Clin. Chem. 46: 506-514 [Abstract] [Full text]  
• Moore, H., Adamson, A. J, Gill, T., Waine, C. (2000). Nutrition and the health care agenda: a primary care perspective. Fam Pract 17: 197-202 [Abstract] [Full text]  
• Law, M. (2000). Plant sterol and stanol margarines and health. BMJ 320: 861-864 [Full text]  
• Jackson, R. (2000). Guidelines on preventing cardiovascular disease in clinical practice. BMJ 320: 659-661 [Full text]