In light of ALLHAT’s lipid-lowering component results, should I change my pharmacologic approach to lipid lowering in my patients at high risk for coronary disease?
Pharmacologic approaches to lipid lowering should not be altered if they are instituted for appropriate indications (e.g., coronary risk reduction), have a clear therapeutic goal (e.g., adequate LDL-C reduction), and are monitored properly. ALLHAT’s lipid-lowering component was designed to determine whether lowering cholesterol with an HMG Co-A reductase inhibitor (pravastatin) compared with usual care reduced all-cause mortality in older hypertensive persons with moderate hypercholesterolemia. ALLHAT is consistent with current recommendations for lipid control in the prevention and treatment of cardiovascular disease and does not refute results of other published long-term “statin” trials.
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