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In this study, 480,000 American men aged thirty-five to fifty-nine were screened, yielding 18,000 with blood cholesterol levels of at least 265mg/dl. For four months, these 18,000 men were asked to stick to a cholesterol-lowering diet. The 80 percent who did so successfully, and brought their cholesterol down to normal levels, were then asked to continue on their diet. The rest of the trial concentrated on the 20 percent (3,806 men) who were then given drug treatment, or a placebo (the control group).
The drug used was cholestyramine (Questran), which has a different action from clofibrate. After seven years, the drug-treated group had blood cholesterol levels 9 percent lower than the controls; they had a 19 percent lower rate of fatal and nonfatal heart attacks; there were 20 percent fewer cases of angina; and they needed 21 percent fewer coronary bypass operations.
These findings have, however, created enthusiasm for treating high-risk angina patients (high blood cholesterol) with cholestyramine, and certainly for vigorously promoting a diet for them that would lower their cholesterol levels. Whether there would be much benefit in promoting the treatment for men with lower blood cholesterol levels remains in doubt.
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