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The National Cholesterol Education Program has introduced an optional LDL-cholesterol goal of <70 mg/dL for patients at very high risk for coronary heart disease, even when baseline levels are <100 mg/dL (Journal Watch Cardiology Sep 3 2004). Adding to the ongoing debate, researchers have conducted a manufacturer-sponsored, double-blind, international trial in which 10,001 patients (mean age, 61; 81% men; 94% white) with clinically evident stable CHD were randomized to receive daily atorvastatin at either 10 mg (LDL goal, 100 mg/dL) or 80 mg (LDL goal, 75 mg/dL). Patients were randomized only if 8-week run-in treatment with open-label 10-mg atorvastatin achieved an LDL level <130 mg/dL.
A significant difference in LDL level emerged between h…