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Several trials of cholesterol-lowering drugs in patients without known coronary disease have shown reductions in coronary events but trends toward increased noncoronary death. This randomized study compared pravastatin (40 mg/day) with placebo in 6595 hypercholesterolemic Scottish men, age 45 to 64, with no history of myocardial infarction. Nearly 80 percent of the men were current or ex-smokers, and 5 percent had angina. At baseline, the mean total, LDL, and HDL cholesterol levels were 272, 192, and 44 mg/dl, respectively. Pravastatin reduced LDL cholesterol by 26 percent (versus no change in the placebo group). During a mean follow-up of five years, the rate of nonfatal MI or death from coronary disease was 5.5 percent in the pravastatin …