Cholesterol reduction in coronary artery bypass patients

This issue ofThe Journalcontains an article by Blanken-horn et al1that deserves, dear reader, your careful scrutiny. Aggressive diet and drug therapy appear to have led to sustained large reductions in blood cholesterol levels and, more importantly, to a reduced rate of development and progression of coronary artery and vein bypass graft lesions in patients who have undergone aortocoronary bypass graft surgery. The study is a substantial addition to the already extensive body of literature that links blood cholesterol level to atherosclerotic vascular disease in general and to coronary artery disease in particular.2-6The implications of this study for the several million individuals who have undergone coronary bypass surgery are substantial. Coronary artery disease remains a major public health problem in the United States, despite an encouraging 37% reduction in age-adjusted mortality rates noted during the last two decades.7In 1985, an estimated 540 000