Clinical trials for the reduction of coronary artery disease: a critical review

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Our present knowledge about risk factors and cardiovascular events has a solid foundation in epidemiological studies. However, if it is clear that the link between risk factors and events is represented by the pathogenetic role that hypertension, hypercholesterolaemia and cigarette-smoking have in arterial atherosclerotic disease, we still do not know whether these risk factors contribute to the progression from silent atherosclerosis to atherosclerotic events. This may explain some of the difficulties we have in interpreting the results of primary prevention trials. The anatomical regression of atherosclerotic plaques obtained by treating risk factors could be the clue to a better understanding of the clinical phenomena

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