Cholesterol and Clinical Decisions

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To the editor: Kannel and associates in the January issue provide an excellent review of the epidemiologic data relating lipids and lipoproteins to atherosclerosis (1). On the whole, the statistical significance obtained in these studies is impressive. Unfortunately, I believe that in the segment of their paper relating to clinical implications, the difference between statistical and clinical significance is not emphasized strongly enough and their recommendations will lead to an unnecessary increase in medical costs. As can be clearly seen in their Figure 2, most patients with or without coronary heart disease have total serum cholesterol values ranging from 150

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