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[Target levels for LDL cholesterol are put out of the running. Cholesterol should be lowered maximally in high cardiovascular risk].

In an expanded meta analysis from the Cholesterol Treatment Trialists (CTT) Collaboration, incorporating additional five trials of more versus less statin therapy, was demonstrated that one additional mmol/L LDL cholesterol reduction safely decreases the risk of major vascular events, regardless of initial LDL cholesterol level by about one fifth. The CTT authors suggest that patients with high risk of cardiovascular events would benefit from intensive statin therapy even if baseline LDL cholesterol is below 2 mmol/L. The Scandinavian IDEAL trial also indicates that health benefits could be obtained with statin therapies resulting in LDL cholesterol below 2,0 mmol/L compared with study participants not reaching this level. The author suggests a reconsideration of the goal for LDL cholesterol in secondary prevention in Sweden and that all high-risk patients with an initial LDL cholesterol under 2.0 mmol/L also should be treated with statins.