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The “Lipid Hypothesis” of cardiovascular disease (CVD)—stating that cholesterol is causal in the development of atherosclerotic cardiovascular disease (ASCVD) and that lowering of cholesterol is associated with lower cardiovascular event rates—is widely accepted throughout the medical community. For patients with known CVD (secondary prevention), studies have shown that cholesterol lowering leads to a consistent reduction in total mortality and in recurrent cardiovascular events in men and women; other studies have documented lowered mortality and events in middle-aged and older patients. Among patients without CVD (primary prevention), the data are generally consistent, with rates of cardiovascular events, heart disease mortality, and all-cause mortality differing among studies. Treatment guidelines have been designed to assist clinicians in selecting patients for cholesterol-lowering therapy based predominantly on their overall risk of developing CVD as well as their baseline cholesterol levels.

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