Target levels for low-density lipoprotein in patients with coronary heart disease

To the Editor. —I am writing in reference to the recently published Summary of the Second Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II).1The initial guidelines issued by this panel 5 years ago were enormously influential in shaping practice and focusing the debate in this area. Undoubtedly, this update will be widely read and extensively discussed as well. It is therefore unfortunate that the article presents the panel's conclusions without providing its rationale. The article is unreferenced and there is no mention of the methods used to gather and analyze the relevant supporting evidence. The decision to lower the low-density lipoprotein (LDL) cholesterol goal for coronary heart disease (CHD) patients to 100 mg/dL (2.6 mmol/L) is one example of a controversial recommendation2for which a discussion of the supporting data