Cholesterol and coronary heart disease. The importance of patient-specific attributable risk
- 1 October 1988
- journal article
- research article
- Published by American Medical Association (AMA) in Archives of Internal Medicine
- Vol. 148 (10), 2247-2252
- https://doi.org/10.1001/archinte.148.10.2247
Abstract
The value of treating hypercholesterolemia remains controversial despite extensive investigation, in part because of the research orientation of much of the relevant literature. Most published studies report relative measures of risks such as the risk ratio. However, clinicians are concerned with the magnitude of risk, or attributable risk, the difference in risk in those with highest and lowest serum cholesterol levels. Since maximum risk modification is rarely achieved, the attributable risk often overstates the potential benefit of risk factor reduction. A variant of the attributable risk, the practical attributale risk, gives a more realistic estimate of potential benefit. Since clinicians treat individuals and not populations, these measures of risk are most useful if reported for subgroups of patients (e.g., men and women, as well as those of varying age). To illustrate these concepts, we review the literature on hypercholesterolemia, report the risk ratio, attributable risk, and practical attributable risk for important patient populations, and discuss the implications for clinical practice.This publication has 13 references indexed in Scilit:
- Cholesterol Reduction and Life ExpectancyAnnals of Internal Medicine, 1987
- RELATIONSHIP OF CLINICAL DIABETES AND ASYMPTOMATIC HYPERGLYCEMIA TO RISK OF CORONARY HEART DISEASE MORTALITY IN MEN AND WOMENAmerican Journal of Epidemiology, 1986
- CARDIOVASCULAR DISEASE RISK FACTORS AND MORTALITY AMONG BLACK WOMEN AND WHITE WOMEN AGED 40–64 YEARS IN EVANS COUNTY, GEORGIAAmerican Journal of Epidemiology, 1986
- MORTALITY FROM CORONARY HEART DISEASE IN THE TECUMSEH STUDYAmerican Journal of Epidemiology, 1985
- SEX DIFFERENTIAL IN ISCHEMIC HEART DISEASE MORTALITY IN DIABETICS: A PROSPECTIVE POPULATION-BASED STUDYAmerican Journal of Epidemiology, 1983
- Mortality from coronary heart disease and stroke in relation to degree of glycaemia: the Whitehall study.BMJ, 1983
- Summary estimates of cholesterol used to predict coronary heart disease.Circulation, 1983
- RISK-FACTORS FOR DEATH FOR MALES AND FEMALES - A STUDY OF THE DEATH PATTERN IN THE STOCKHOLM PROSPECTIVE-STUDY1982
- ASSOCIATIONS OF SERUM HIGH DENSITY LIPOPROTEIN AND TOTAL CHOLESTEROL WITH TOTAL, CARDIOVASCULAR, AND CANCER MORTALITY IN A 7-YEAR PROSPECTIVE STUDY OF 10 000 MENThe Lancet, 1981
- Dietary Prevention of Coronary Heart Disease: The Finnish Mental Hospital StudyInternational Journal of Epidemiology, 1979