© 2002 by Heart
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Ischaemic heart disease
Statin treatment: the longer the better 
At what concentration of cholesterol should treatment be initiated? The answer from the heart protection study (HPS) seems to be anything above a total cholesterol of 3.5 mmol/l. The cost effectiveness seems to improve on long term treatment as more events are prevented. The LIPID study cohort was followed for two years beyond the initial six years of the trial, and allowed to take open label pravastatin (> 80% in each group). The group who had initially been assigned to placebo still appeared to have more events in this period than those initially on statin treatment, despite similar cholesterol concentrations, suggesting a long term effect with a 1–2 year lag time.
The LIPID Study Group. Long-term effectiveness and safety of pravastatin in 9014 patients with coronary heart disease and average cholesterol concentrations: the LIPID trial follow-up. Lancet 2002;359:1379–87.[Medline]
Collins R
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