BMJ  2003;326:1423 (28 June), doi:10.1136/bmj.326.7404.1423

Paper

Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis

¹ Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and the London, Queen Mary's School of Medicine and Dentistry, University of London, London EC1M 6BQ

Objectives To determine by how much statins reduce serum concentrations of low density lipoprotein (LDL) cholesterol and incidence of ischaemic heart disease (IHD) events and stroke, according to drug, dose, and duration of treatment.

Design Three meta-analyses: 164 short term randomised placebo controlled trials of six statins and LDL cholesterol reduction; 58 randomised trials of cholesterol lowering by any means and IHD events; and nine cohort studies and the same 58 trials on stoke.

Main outcome measures Reductions in LDL cholesterol according to statin and dose; reduction in IHD events and stroke for a specified reduction in LDL cholesterol.

Results Reductions in LDL cholesterol (in the 164 trials) were 2.8 mmol/l (60%) with rosuvastatin 80 mg/day, 2.6 mmol/l (55%) with atorvastatin 80 mg/day, 1.8 mmol/l (40%) with atorvastatin 10 mg/day, lovastatin 40 mg/day, simvastatin 40 mg/day, or rosuvastatin 5 mg/day, all from pretreatment concentrations of 4.8 mmol/l. Pravastatin and fluvastatin achieved smaller reductions. In the 58 trials, for an LDL cholesterol reduction of 1.0 mmol/l the risk of IHD events was reduced by 11% in the first year of treatment, 24% in the second year, 33% in years three to five, and by 36% thereafter (P < 0.001 for trend). IHD events were reduced by 20%, 31%, and 51% in trials grouped by LDL cholesterol reduction (means 0.5 mmol/l, 1.0 mmol/l, and 1.6 mmol/l) after results from first two years of treatment were excluded (P < 0.001 for trend). After several years a reduction of 1.8 mmol/l would reduce IHD events by an estimated 61%. Results from the same 58 trials, corroborated by results from the nine cohort studies, show that lowering LDL cholesterol decreases all stroke by 10% for a 1 mmol/l reduction and 17% for a 1.8 mmol/l reduction. Estimates allow for the fact that trials tended to recruit people with vascular disease, among whom the effect of LDL cholesterol reduction on stroke is greater because of their higher risk of thromboembolic stroke (rather than haemorrhagic stroke) compared with people in the general population.

Conclusions Statins can lower LDL cholesterol concentration by an average of 1.8 mmol/l which reduces the risk of IHD events by about 60% and stroke by 17%.

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• Manisty, C., Mayet, J., Tapp, R. J., Sever, P. S., Poulter, N., McG. Thom, S. A., Hughes, A. D., on behalf of the ASCOT Investigators, (2009). Atorvastatin Treatment Is Associated With Less Augmentation of the Carotid Pressure Waveform in Hypertension: A Substudy of the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT). Hypertension 54: 1009-1013 [Abstract] [Full text]  
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• Tremblay, A. J, Lamarche, B., Hogue, J.-C., Couture, P. (2009). Effects of ezetimibe and simvastatin on apolipoprotein B metabolism in males with mixed hyperlipidemia. J. Lipid Res. 50: 1463-1471 [Abstract] [Full text]  
• Brugts, J J, Yetgin, T, Hoeks, S E, Gotto, A M, Shepherd, J, Westendorp, R G J, de Craen, A J M, Knopp, R H, Nakamura, H, Ridker, P, van Domburg, R, Deckers, J W (2009). The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials. BMJ 338: b2376-b2376 [Abstract] [Full text]  
• Basu, A., Tang, H., Lewis, C. E., North, K., Curb, J. D., Quertermous, T., Mosley, T. H., Boerwinkle, E., Zhu, X., Risch, N. J. (2009). Admixture mapping of quantitative trait loci for blood lipids in African-Americans. Hum Mol Genet 18: 2091-2098 [Abstract] [Full text]  
• Nakayama, K, Bayasgalan, T, Yamanaka, K, Kumada, M, Gotoh, T, Utsumi, N, Yanagisawa, Y, Okayama, M, Kajii, E, Ishibashi, S, Iwamoto, S, The Jichi Community Genetics Team (JCOG), (2009). Large scale replication analysis of loci associated with lipid concentrations in a Japanese population. J. Med. Genet. 46: 370-374 [Abstract] [Full text]  
• Law, M R, Morris, J K, Wald, N J (2009). Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 338: b1665-b1665 [Abstract] [Full text]  
• Neil, A., Humphries, S. E (2009). Statins and familial hypercholesterolaemia. BMJ 338: a3041-a3041 [Full text]  
• Zannad, F., Bousquet, P., Monassier, L. (2009). CHAPTER 11 Clinical Pharmacology of Cardiovascular Drugs. ESC Textbook of Cardiovascular Medicine 2: med-9780199566990-chapter-med-9780199566990-chapter [Abstract] [Full text]  
• Talelli, P., Greenwood, R. J. (2008). Review: Recurrent stroke: where do we stand with the secondary prevention of noncardioembolic ischaemic strokes?. Ther Adv Cardiovasc Dis 2: 387-405 [Abstract]  
• Mann, D., Reynolds, K., Smith, D., Muntner, P. (2008). Trends in Statin Use and Low-Density Lipoprotein Cholesterol Levels Among US Adults: Impact of the 2001 National Cholesterol Education Program Guidelines. The Annals of Pharmacotherapy 42: 1208-1215 [Abstract] [Full text]  
• Bhatnagar, D., Soran, H., Durrington, P. N (2008). Hypercholesterolaemia and its management. BMJ 337: a993-a993 [Full text]  
• Arslan, F., Pasterkamp, G., de Kleijn, D. P. (2008). Unraveling Pleiotropic Effects Of Statins: Bit By Bit, a Slow Case With Perspective. Circ. Res. 103: 334-336 [Full text]  
• Owen, C. G, Whincup, P. H, Kaye, S. J, Martin, R. M, Davey Smith, G., Cook, D. G, Bergstrom, E., Black, S., Wadsworth, M. E., Fall, C. H, Freudenheim, J. L, Nie, J., Huxley, R. R, Kolacek, S., Leeson, C P., Pearce, M. S, Raitakari, O. T, Lisinen, I., Viikari, J. S, Ravelli, A. C, Rudnicka, A. R, Strachan, D. P, Williams, S. M (2008). Does initial breastfeeding lead to lower blood cholesterol in adult life? A quantitative review of the evidence. Am. J. Clin. Nutr. 88: 305-314 [Abstract] [Full text]  
• Sudlow, C (2008). Preventing further vascular events after a stroke or transient ischaemic attack: an update on medical management. PN 8: 141-157 [Abstract] [Full text]  
• Petty, D., Lloyd, D. (2008). Can cheap generic statins achieve national cholesterol lowering targets?. J Health Serv Res Policy 13: 99-102 [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]  
• Levine, A. P., Mikhailidis, D. P., Moross, T., Benson, K., Gor, M. (2008). Achieving Vascular Risk Factor Targets: A Survey of a London General Practice. ANGIOLOGY 59: 36-46 [Abstract]  
• Paraskevas, K. I. (2008). Applications of statins in cardiothoracic surgery: more than just lipid-lowering. Eur. J. Cardiothorac. Surg. 33: 377-390 [Abstract] [Full text]  
• Jackson, R. (2008). Cardiovascular risk prediction: are we there yet?. Heart 94: 1-3 [Full text]  
• Charlton-Menys, V., Durrington, P. N. (2008). Human cholesterol metabolism and therapeutic molecules. Exp Physiol 93: 27-42 [Abstract] [Full text]  
• Ferdinandy, P., Schulz, R., Baxter, G. F. (2007). Interaction of Cardiovascular Risk Factors with Myocardial Ischemia/Reperfusion Injury, Preconditioning, and Postconditioning. Pharmacol. Rev. 59: 418-458 [Abstract] [Full text]  
• Grover, S. A., Lowensteyn, I., Joseph, L., Kaouache, M., Marchand, S., Coupal, L., Boudreau, G., for the Cardiovascular Health Evaluation to Improv, (2007). Patient Knowledge of Coronary Risk Profile Improves the Effectiveness of Dyslipidemia Therapy: The CHECK-UP Study: A Randomized Controlled Trial. Arch Intern Med 167: 2296-2303 [Abstract] [Full text]  
• Mudd, J. O., Borlaug, B. A., Johnston, P. V., Kral, B. G., Rouf, R., Blumenthal, R. S., Kwiterovich, P. O. Jr (2007). Beyond Low-Density Lipoprotein Cholesterol: Defining the Role of Low-Density Lipoprotein Heterogeneity in Coronary Artery Disease. J Am Coll Cardiol 50: 1735-1741 [Abstract] [Full text]  
• Kulik, A., Levin, R., Ruel, M., Mesana, T. G., Solomon, D. H., Choudhry, N. K. (2007). Patterns and predictors of statin use after coronary artery bypass graft surgery.. J. Thorac. Cardiovasc. Surg. 134: 932-938 [Abstract] [Full text]  
• Wald, D. S, Morton, G., Walker, K., Iosson, N., Curzen, N. P (2007). Long-Term Continuation on Cardiovascular Drug Treatment in Patients with Coronary Heart Disease. The Annals of Pharmacotherapy 41: 1644-1647 [Abstract] [Full text]  
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• Choudhry, N. K, Levin, R., Winkelmayer, W. C (2007). Statins in elderly patients with acute coronary syndrome: an analysis of dose and class effects in typical practice. Heart 93: 945-951 [Abstract] [Full text]  
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• Le Manach, Y., Godet, G., Coriat, P., Martinon, C., Bertrand, M., Fleron, M.-H., Riou, B. (2007). The Impact of Postoperative Discontinuation or Continuation of Chronic Statin Therapy on Cardiac Outcome After Major Vascular Surgery. Anesth. Analg. 104: 1326-1333 [Abstract] [Full text]  
• (2007). Which statin, what dose?. DTB 45: 33-37 [Abstract] [Full text]  
• Christensen, R., Bartels, E. M., Astrup, A., Bliddal, H. (2007). Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis. Ann Rheum Dis 66: 433-439 [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]  
• Dzau, V. J., Antman, E. M., Black, H. R., Hayes, D. L., Manson, J. E., Plutzky, J., Popma, J. J., Stevenson, W. (2006). The Cardiovascular Disease Continuum Validated: Clinical Evidence of Improved Patient Outcomes: Part I: Pathophysiology and Clinical Trial Evidence (Risk Factors Through Stable Coronary Artery Disease). Circulation 114: 2850-2870 [Full text]  
• de Lusignan, S., Belsey, J., Hague, N., Dhoul, N., van Vlymen, J. (2006). Audit-based education to reduce suboptimal management of cholesterol in primary care: a before and after study. J Public Health (Oxf) 28: 361-369 [Abstract] [Full text]  
• Wald, D. S, Wald, N. J, Morris, J. K, Law, M. (2006). Folic acid, homocysteine, and cardiovascular disease: judging causality in the face of inconclusive trial evidence. BMJ 333: 1114-1117 [Full text]  
• Atthobari, J., Brantsma, A. H., Gansevoort, R. T., Visser, S. T., Asselbergs, F. W., van Gilst, W. H., de Jong, P. E., de Jong-van den Berg, L. T. W., on behalf of PREVEND study group, (2006). The effect of statins on urinary albumin excretion and glomerular filtration rate: results from both a randomized clinical trial and an observational cohort study. Nephrol Dial Transplant 21: 3106-3114 [Abstract] [Full text]  
• Gemmell, I, Heller, R F, Payne, K, Edwards, R, Roland, M, Durrington, P (2006). Potential population impact of the UK government strategy for reducing the burden of coronary heart disease in England: comparing primary and secondary prevention strategies.. Qual Saf Health Care 15: 339-343 [Abstract] [Full text]  
• Carod-Artal, F. J. (2006). Statins and Cerebral Vasomotor Reactivity: Implications for a New Therapy?. Stroke 37: 2446-2448 [Full text]  
• Sirikulchayanonta, C., Pavadhgul, P., Chongsuwat, R., Srisorrachata, S. (2006). A preliminary study of hyperlipidemia in Bangkok school children. Asia Pac J Public Health 18: 15-19  
• van Zwieten, P. A., Mancia, G. (2006). Background and treatment of metabolic syndrome: a therapeutic challenge.. SEMIN CARDIOTHORAC VASC ANESTH 10: 206-214 [Abstract]  
• Mcelduff, P, Jaefarnezhad, M, Durrington, P N (2006). American, British and European recommendations for statins in the primary prevention of cardiovascular disease applied to British men studied prospectively. Heart 92: 1213-1218 [Abstract] [Full text]  
• El-Saed, A., Kuller, L. H., Newman, A. B., Lopez, O., Costantino, J., McTigue, K., Cushman, M., Kronmal, R. (2006). Factors Associated With Geographic Variations in Stroke Incidence Among Older Populations in Four US Communities. Stroke 37: 1980-1985 [Abstract] [Full text]  
• Mittleman, M. A. (2006). A 39-year-old woman with hypercholesterolemia.. JAMA 296: 319-326 [Abstract] [Full text]  
• Smellie, W S. A (2006). Testing pitfalls and summary of guidance in lipid management. BMJ 333: 83-86 [Full text]  
• Sleight, P., Pouleur, H., Zannad, F. (2006). Benefits, challenges, and registerability of the polypill. Eur Heart J 27: 1651-1656 [Abstract] [Full text]  
• 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]  
• Crowe, F. L, Skeaff, C M., Green, T. J, Gray, A. R (2006). Serum fatty acids as biomarkers of fat intake predict serum cholesterol concentrations in a population-based survey of New Zealand adolescents and adults.. Am. J. Clin. Nutr. 83: 887-894 [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]  
• Deckers, J. W., Goedhart, D. M., Boersma, E., Briggs, A., Bertrand, M., Ferrari, R., Remme, W. J., Fox, K., Simoons, M. L., on behalf of the EUROPA Investigators, (2006). Treatment benefit by perindopril in patients with stable coronary artery disease at different levels of risk. Eur Heart J 27: 796-801 [Abstract] [Full text]  
• D'Amico, G. (2006). Statins and Renal Diseases: From Primary Prevention to Renal Replacement Therapy.. J. Am. Soc. Nephrol. 17: S148-S152 [Abstract] [Full text]  
• Cohen, J. C., Boerwinkle, E., Mosley, T. H. Jr., Hobbs, H. H. (2006). Sequence variations in PCSK9, low LDL, and protection against coronary heart disease.. NEJM 354: 1264-1272 [Abstract] [Full text]  
• Franco, O. H, Steyerberg, E. W, de Laet, C. (2006). The polypill: at what price would it become cost effective?. J. Epidemiol. Community Health 60: 213-217 [Abstract] [Full text]  
• Moruisi, K. G., Oosthuizen, W., Opperman, A. M. (2006). Phytosterols/Stanols lower cholesterol concentrations in familial hypercholesterolemic subjects: a systematic review with meta-analysis.. J. Am. Coll. Nutr. 25: 41-48 [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]  
• Pearson, G. J, Koshman, S. L, Lalonde, L. D, Burton, I., Tymchak, W. J (2005). . The Annals of Pharmacotherapy 39: 2142-2142 [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]  
• Fletcher, B., Berra, K., Ades, P., Braun, L. T., Burke, L. E., Durstine, J. L., Fair, J. M., Fletcher, G. F., Goff, D., Hayman, L. L., Hiatt, W. R., Miller, N. H., Krauss, R., Kris-Etherton, P., Stone, N., Wilterdink, J., Winston, M. (2005). Managing Abnormal Blood Lipids: A Collaborative Approach. Circulation 112: 3184-3209 [Abstract] [Full text]  
• Knoll, G., Cockfield, S., Blydt-Hansen, T., Baran, D., Kiberd, B., Landsberg, D., Rush, D., Cole, E., for The Kidney Transplant Working Group of the Can, (2005). Canadian Society of Transplantation: consensus guidelines on eligibility for kidney transplantation. CMAJ 173: S1-S25 [Full text]  
• Franco, O. H, Peeters, A., Looman, C. W N, Bonneux, L. (2005). Cost effectiveness of statins in coronary heart disease. J. Epidemiol. Community Health 59: 927-933 [Abstract] [Full text]  
• Fonarow, G. C. (2005). In-Hospital Initiation of Statin Therapy in Acute Coronary Syndromes: Maximizing the Early and Long-term Benefits. Chest 128: 3641-3651 [Abstract] [Full text]  
• Bruckert, E. (2005). Impact of lipid treatment on cardiovascular risk reduction: new therapeutic targets. Eur Heart J Suppl 7: L16-L20 [Abstract] [Full text]  
• Smellie, W S A, Wilson, D, McNulty, C A M, Galloway, M J, Spickett, G A, Finnigan, D I, Bareford, D A, Greig, M A, Richards, J (2005). Best practice in primary care pathology: review 1. J. Clin. Pathol. 58: 1016-1024 [Abstract] [Full text]  
• Paraskevas, K. I., Daskalopoulou, S. S., Daskalopoulos, M. E., Liapis, C. D. (2005). Secondary Prevention of Ischemic Cerebrovascular Disease. What Is the Evidence?. ANGIOLOGY 56: 539-552 [Abstract]  
• Hayashida, K., Kume, N., Murase, T., Minami, M., Nakagawa, D., Inada, T., Tanaka, M., Ueda, A., Kominami, G., Kambara, H., Kimura, T., Kita, T. (2005). Serum Soluble Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1 Levels Are Elevated in Acute Coronary Syndrome: A Novel Marker for Early Diagnosis. Circulation 112: 812-818 [Abstract] [Full text]  
• Ioannidis, J. P. A. (2005). Contradicted and Initially Stronger Effects in Highly Cited Clinical Research. JAMA 294: 218-228 [Abstract] [Full text]  
• Soljanlahti, S., Autti, T., Lauerma, K., Raininko, R., Keto, P., Turtola, H., Vuorio, A. F. (2005). Familial Hypercholesterolemia Patients Treated With Statins at No Increased Risk for Intracranial Vascular Lesions Despite Increased Cholesterol Burden and Extracranial Atherosclerosis. Stroke 36: 1572-1574 [Abstract] [Full text]  
• Cohn, J. N., Duprez, D. A., Grandits, G. A. (2005). Arterial Elasticity as Part of a Comprehensive Assessment of Cardiovascular Risk and Drug Treatment. Hypertension 46: 217-220 [Abstract] [Full text]  
• Choudhry, N. K., Avorn, J. (2005). Over-the-Counter Statins. ANN INTERN MED 142: 910-913 [Abstract] [Full text]  
• Katritsis, D. G., Ioannidis, J. P.A. (2005). Percutaneous Coronary Intervention Versus Conservative Therapy in Nonacute Coronary Artery Disease: A Meta-Analysis. Circulation 111: 2906-2912 [Abstract] [Full text]  
• Chapman, R. H., Benner, J. S., Petrilla, A. A., Tierce, J. C., Collins, S. R., Battleman, D. S., Schwartz, J. S. (2005). Predictors of Adherence With Antihypertensive and Lipid-Lowering Therapy. Arch Intern Med 165: 1147-1152 [Abstract] [Full text]  
• Zhou, Z., Rahme, E., Abrahamowicz, M., Tu, J. V., Eisenberg, M. J., Humphries, K., Austin, P. C., Pilote, L. (2005). Effectiveness of statins for secondary prevention in elderly patients after acute myocardial infarction: an evaluation of class effect. CMAJ 172: 1187-1194 [Abstract] [Full text]  
• Wright, J. M. (2005). Are the benefits of statins a class effect?. CMAJ 172: 1195-1196 [Full text]  
• Schulz, R. (2005). Pleiotropic effects of statins: Acutely good, but chronically bad?. J Am Coll Cardiol 45: 1292-1294 [Full text]  
• (2005). Simvastatin over the counter. DTB 43: 25-28 [Abstract] [Full text]  
• Vasan, R. S., Sullivan, L. M., Wilson, P. W.F., Sempos, C. T., Sundstrom, J., Kannel, W. B., Levy, D., D'Agostino, R. B. (2005). Relative Importance of Borderline and Elevated Levels of Coronary Heart Disease Risk Factors. ANN INTERN MED 142: 393-402 [Abstract] [Full text]  
• Johnson-Anuna, L. N., Eckert, G. P., Keller, J. H., Igbavboa, U., Franke, C., Fechner, T., Schubert-Zsilavecz, M., Karas, M., Muller, W. E., Wood, W. G. (2005). Chronic Administration of Statins Alters Multiple Gene Expression Patterns in Mouse Cerebral Cortex. J. Pharmacol. Exp. Ther. 312: 786-793 [Abstract] [Full text]  
• Undas, A., Brummel-Ziedins, K. E., Mann, K. G. (2005). Statins and Blood Coagulation. Arterioscler. Thromb. Vasc. Bio. 25: 287-294 [Abstract] [Full text]  
• Hankey, G. J. (2005). Secondary Prevention of Recurrent Stroke. Stroke 36: 218-221 [Full text]  
• Huxley, R., Owen, C. G., Whincup, P. H., Cook, D. G., Colman, S., Collins, R. (2004). Birth Weight and Subsequent Cholesterol Levels: Exploration of the "Fetal Origins" Hypothesis. JAMA 292: 2755-2764 [Abstract] [Full text]  
• Corrao, G., Zambon, A., Bertu, L., Botteri, E., Leoni, O., Contiero, P. (2004). Lipid lowering drugs prescription and the risk of peripheral neuropathy: an exploratory case-control study using automated databases. J. Epidemiol. Community Health 58: 1047-1051 [Abstract] [Full text]  
• Wong, J., Quinn, C. M., Brown, A. J. (2004). Statins Inhibit Synthesis of an Oxysterol Ligand for the Liver X Receptor in Human Macrophages With Consequences for Cholesterol Flux. Arterioscler. Thromb. Vasc. Bio. 24: 2365-2371 [Abstract] [Full text]  
• Brown, L. C., Johnson, J. A., Majumdar, S. R., Tsuyuki, R. T., McAlister, F. A. (2004). Evidence of suboptimal management of cardiovascular risk in patients with type 2 diabetes mellitus and symptomatic atherosclerosis. CMAJ 171: 1189-1192 [Abstract] [Full text]  
• Gwinn-Hardy, K., Dawson, V. (2004). Genomics-Proteomics and Stroke: Introduction. Stroke 35: 2731-2734 [Full text]  
• Stone, N. J. (2004). Stopping Statins. Circulation 110: 2280-2282 [Full text]  
• Narayan, K.M. V. (2004). "Polypill" for Cardiovascular Disease Prevention. Clin. Diabetes 22: 157-158 [Abstract] [Full text]  
• (2004). {blacktriangledown}Ezetimibe - a new cholesterol-lowering drug. DTB 42: 65-67 [Abstract] [Full text]  
• Strandberg, T. E., Strandberg, A., Rantanen, K., Salomaa, V. V., Pitkala, K., Miettinen, T. A. (2004). Low cholesterol, mortality, and quality of life in old age during a 39-year follow-up. J Am Coll Cardiol 44: 1002-1008 [Abstract] [Full text]  
• Robinson, G V, Pepperell, J C T, Segal, H C, Davies, R J O, Stradling, J R (2004). Circulating cardiovascular risk factors in obstructive sleep apnoea: data from randomised controlled trials. Thorax 59: 777-782 [Abstract] [Full text]  

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