Hit or miss: the new cholesterol targets.
Level 1 - systematic review of randomized trials
Systematic review of randomized controlled trials
PubMed 32747335 · doi:10.1136/bmjebm-2020-111413
What was done
The authors conducted a systematic review of 35 randomized controlled trials evaluating drug treatment to achieve recommended cholesterol targets across four moderate- to high-risk patient populations: patients with prior cardiovascular events, adults with diabetes, individuals with low-density lipoprotein cholesterol (LDL-C) ≥190 mg/dL, and individuals with an estimated 10-year cardiovascular risk ≥7.5%.
What was found
Achieving recommended cholesterol target levels did not confer additional benefit across the 35 randomized controlled trials. No specific numerical risk estimates, relative risks, or confidence intervals were reported in the abstract.
Why it matters
The findings challenge guideline-recommended LDL-C targets and cardiovascular risk calculation thresholds, questioning the use of LDL-C as a surrogate target for cardiovascular prevention.
Limits
The abstract provides no numerical data, effect sizes, or confidence intervals, and omits details regarding specific drug classes, trial endpoints, follow-up durations, or heterogeneity across the 35 trials.
Cited by
- supports A systematic review of over 30 randomized controlled trials found no clear relationship between the degree of LDL reduction from cholesterol-lowering drugs and prevention of cardiovascular events.