RT Journal
A1 de Lorgeril M, Salen P, Rabeus M
T1 Primary prevention cardiovascular disease: Better than drugs—reply
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2011
FD November 8
VO 170
IS 20
SP 1860
OP 1861
DO 10.1001/archinternmed.2010.403
UL http://dx.doi.org/10.1001/archinternmed.2010.403
AB 
Pippin proposes the adoption of a plant-based dietary pattern. We again agree that this strategy is probably better—both in terms of clinical efficiency and “side effects”—than taking a statin. Pippin backs his recommendation on the basis of the 52-nation INTERHEART study and the 2006 American Heart Association (AHA) Diet and Lifestyle Recommendations, as cited in his letter. However, evidence-based preventive medicine should primarily be based on randomized clinical trials. Neither INTERHEART (a case-control study) nor the 2006 AHA Recommendations (in which no clinical trial was cited) provide convincing evidence. This would reinforce the widespread idea that in the supposed absence of dietary trial, it is reassuring to use cholesterol-lowering drugs, despite the present statin controversy.