Standardisation of studies by absolute LDL reduction systematically misestimates CV RRR*
| Baseline LDL (mg/dL) | Treated LDL (mg/dL) | Absolute LDL reduction (mg/dL) | Proportional LDL reduction (%) | CV RRR per 40 mg/dL LDL reduction | CV RRR per 40% LDL reduction | |
|---|---|---|---|---|---|---|
| JUPITER | 108 | 55 | 53 | 49 | 0.33 | 0.35 |
| SSSS | 188 | 122 | 66 | 35 | 0.18 | 0.34 |
*This illustrates the difference between standardising trials based on absolute versus per cent reduction. JUPITER, a study with lower-risk low-LDL participants appears to have much greater benefit per amount of absolute LDL reduction (RRR 33%) than 4S, a study with higher-risk higher-LDL participants (RRR 18%). One might conclude that lower risk participants receive more benefit per LDL reduction than high-risk participants. However, when standardised as per cent reduction, JUPITER and 4S participants receive almost identical relative CV benefit (RRR of 35% vs 34%, respectively).
CV, cardiovascular; LDL, low-density lipoprotein; RRR, relative risk reduction.