标题：Thematic review series: The Pathogenesis of Atherosclerosis. An interpretive history of the cholesterol controversy, part IV: The 1984 Coronary Primary Prevention Trial ends it--almost
出版社：American Society for Biochemistry and Molecular Biology
摘要：As of the early 1980s, despite the wealth of evidence from experimentalanimal models, the extensive epidemiologic evidence, the powerfulgenetic evidence, and the strongly suggestive clinical interventiontrial results, most clinicians still remained unpersuaded regardingthe relevance of the lipid hypothesis. What was needed was awell-designed, large-scale, long-term, double-blind study demonstratinga statistically significant impact of treatment on coronaryheart disease events. The National Institutes of Health (NIH)had laid the groundwork for such a study as early as 1970, butthe study was not completed and the results published until1984. This study, the Coronary Primary Prevention Trial, showedthat treatment with a bile acid binding resin reduced majorcoronary events in hypercholesterolemic men by 19%, with a Pvalue of 0.05. The NIH followed this up with a national ConsensusDevelopment Conference on Lowering Blood Cholesterol to PreventHeart Disease. For the first time, the NIH now went on recordadvocating screening for hypercholesterolemia and urging aggressivetreatment for those at high risk. The Institute initiated anational cooperative program to that end, the National CholesterolEducation Program. For the first time, preventing coronary heartdisease became a national public health goal.Supplementary key words cholestyramine • National Cholesterol Education Program • coronary heart disease
