Re: Cheese
- From: David Rind <drind@xxxxxxxxxxxxxxxxxxxxx>
- Date: Sun, 27 Aug 2006 07:43:10 -0400
Joe Doe wrote:
The reality is you can use surrogate endpoints like LDL reduction to argue for limiting saturated fat consumption.
I'm willing to grant that that is probably true for cardiac mortality, but not for overall mortality. We have relatively little evidence that interventions (other than statins) that reduce LDL lead to a reduction in all-cause mortality in people without known CHD. And even in people with known CHD, high-intensity statin regimens lower LDL more and reduce CHD events more than low-intensity statin regimens, but have no important effect on all-cause mortality.
So I'd be cautious about using LDL reduction as a surrogate for overall improved mortality outcomes. For instance, I'd really like to see a randomized trial showing that ezetimibe has some important benefit for a clinical endpoint rather than a chemical endpoint.
--
David Rind
drind@xxxxxxxxxxxxxxxxxxxxx
.
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