Cholesterol reduction in cardiovascular disease. Clinical benefits and possible mechanisms.

The causal role of an elevated serum cholesterol level in the genesis of atherosclerosis and its clinical sequelae, particularly ischemic heart disease, is now well established. The recognition of this role has been the impetus for numerous trials designed to test the hypothesis that a reduction in the cholesterol level will lead to a reduction in morbidity and mortality from cardiovascular disease. Most of these studies have indeed demonstrated a reduction in the incidence of ischemic cardiac events, and some have also shown a reduction in mortality from cardiovascular disease. Despite this intensive investigation, however, the mechanism (or mechanisms) responsible . . .