Lipid Research Clinics Program

To the Editor.— The report from the LRC-CPPT1documents that hypercholesteremic men randomly allocated to receive cholestyramine and dietary treatment for their type II hyperlipoproteinemia had fewer CHD events than did hypercholesteremic men who were treated with placebo and diet. However, while the incidence of CHD events was significantly reduced in the group receiving cholestyramine, there was no significant survival advantage for this cholestyramine-treated group. Analysis by the Lipid Research Clinics Program revealed that this lack of survival advantage for the cholestyramine-treated group was due, in large part, to an increased number of deaths secondary to trauma among those patients receiving cholestyramine. In this exhaustive study, the program also documented that patients receiving cholestyramine had significantly lower serum carotene levels than did patients receiving placebo, thus suggesting that cholestyramine was in fact causing malabsorption of other fat-soluble materials besides cholesterol. Indeed, for years it has been known that cholestyramine