PT  - JOURNAL ARTICLE
AU  - Robert DuBroff
AU  - Aseem Malhotra
AU  - Michel de Lorgeril
TI  - Hit or miss: the new cholesterol targets
AID  - 10.1136/bmjebm-2020-111413
DP  - 2020 Jul 19
TA  - BMJ Evidence-Based Medicine
PG  - bmjebm-2020-111413
4099  - http://ebm.bmj.com/content/early/2020/08/23/bmjebm-2020-111413.short
4100  - http://ebm.bmj.com/content/early/2020/08/23/bmjebm-2020-111413.full
AB  - Drug treatment to reduce cholesterol to new target levels is now recommended in four moderate- to high-risk patient populations: patients who have already sustained a cardiovascular event, adult diabetic patients, individuals with low density lipoprotein cholesterol levels ≥190 mg/dL and individuals with an estimated 10-year cardiovascular risk ≥7.5%. Achieving these cholesterol target levels did not confer any additional benefit in a systematic review of 35 randomised controlled trials. Recommending cholesterol lowering treatment based on estimated cardiovascular risk fails to identify many high-risk patients and may lead to unnecessary treatment of low-risk individuals. The negative results of numerous cholesterol lowering randomised controlled trials call into question the validity of using low density lipoprotein cholesterol as a surrogate target for the prevention of cardiovascular disease.