Lechleitner M, Patsch J R, Braunsteiner H
Abteilung für Klinische Atheroskleroseforschung, Universitätsklinik für Innere Medizin, Innsbruck.
Wien Klin Wochenschr. 1991;103(17):513-8.
Cardiovascular disease remains the major cause of death in the industrialized world with dyslipidemia, hypertension and cigarette smoking leading a long list of risk factors. Recently, controversy arose from some critical articles expressing concern about the evaluation and interpretation of statistical data of epidemiologic studies. One study using covariance analysis reported an absence of the widely accepted negative association between coronary heart disease (CHD) and high density lipoprotein (HDL) cholesterol. Also criticism was expressed regarding the cost-effectiveness of preventive measures such as the use of lipid lowering drugs on life expectancy. Because of such recent scientific controversy and discussions already taking place in the media, we have summarized in this article recent epidemiologic evidence including a meta-analysis of the major epidemiologic studies on HDL. We have directed particular attention to 3 large epidemiological studies, i.e., the Familial Atherosclerosis Treatment Study (FATS), the Program on the Surgical Control of the Hyperlipidemias (POSCH), and the Cholesterol Lowering Atherosclerosis Study (CLAS), all of which have clearly demonstrated a desirable effect of intensive lipid lowering therapy on coronary lesions.
在工业化国家，心血管疾病仍然是主要的死亡原因，血脂异常、高血压和吸烟是众多风险因素中的主要因素。最近，一些批判性文章引发了争议，这些文章对流行病学研究统计数据的评估和解释表示担忧。一项使用协方差分析的研究报告称，冠心病（CHD）与高密度脂蛋白（HDL）胆固醇之间不存在广泛认可的负相关关系。此外，对于诸如使用降脂药物等预防措施对预期寿命的成本效益也存在批评意见。由于最近的这种科学争议以及媒体上已经展开的讨论，我们在本文中总结了近期的流行病学证据，包括对关于HDL的主要流行病学研究的荟萃分析。我们特别关注了三项大型流行病学研究，即家族性动脉粥样硬化治疗研究（FATS）、高脂血症外科治疗项目（POSCH）和降胆固醇动脉粥样硬化研究（CLAS），所有这些研究都清楚地表明了强化降脂治疗对冠状动脉病变具有理想的效果。
