The Coronary Drug Project

As noted in the first definitive report from the Coronary Drug Project,1physicians face a difficult dilemma concerning pharmacologic therapy of hyperlipidemia in an attempt to prevent first or recurrent episodes of clinical coronary heart disease (CHD). They know that susceptibility to premature CHD is directly related to serum levels of cholesterol, and of low-density and very-low-density lipoproteins. They are also aware that elevated serum lipids-lipoproteins frequently can be reduced over long periods of time by available drugs. However, they lack answers to key questions about these pharmaceutical agents: Do they prevent CHD and prolong life? Are they reasonably safe in long-term usage? The scarcity of scientific data on these critical questions is especially troublesome in view of the fact that prevention or treatment of coronary disease by control of hyperlipidemia makes sense only as long-term therapy, and questions about drug toxicity are especially gnawing under this circumstance. The