The angiographic evidence for lipid-lowering effects in human coronary atherosclerosis regression

This paper reviews reports of angiographic trials that appeared in 1990, including the Lifestyle Heart Trial, which tested the effects of a vegetarian diet, smoking cessation, and stress management; the Program on the Surgical Control of the Hyperlipidemias, a long-term study of partial ileal bypass for cholesterol lowering; the Familial Atherosclerosis Treatment Study, which tested colestipol-niacin and colestipol-lovastatin; the University of California, San Francisco, Specialized Center of Research Study, which tested colestipol-niacin; and the Cholesterol Lowering Atherosclerosis Study, a study of colestipol-niacin in nonsmoking men who had had coronary bypass surgery. Together, the reports clearly confirm that blood lipid-lowering therapy can reduce progression of human coronary atherosclerosis and produce regression in some subjects. These studies used three different procedures to evaluate coronary artery change and add to the overall strength of evidence that coronary atherosclerosis can be modified.