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No trial of lipid-lowering drugs for the primary prevention of coronary heart disease has demonstrated a reduction in mortality -- until now. Between 1989 and 1991, the West of Scotland Coronary Prevention Study Group randomized 6595 hypercholesterolemic men, aged 45 to 64 years, to pravastatin (40 mg daily) or placebo. These men had a nonfasting plasma cholesterol level more than 252 mg/dl. They also had a mean low-density lipoprotein level of 272 mg/dl, based on two measures. In addition, the subjects had neither serious ECG abnormalities nor history of MI. Only 5% had a history of angina.
Pravastatin lowered plasma cholesterol levels by 20% and LDL-cholesterol levels by 26%. Over an average of 4.9 years of follow-up (32,216 subject-years)…