I think that for very-high-risk people, the
newly-lowered 'desirable' LDL levels are probably
reasonable, but when guidelines are issued by a
committee with 6 of 9 members as paid consultants of
various pharmaceutical companies, that information
ought to be noted more than every 3 years. (Looks like
it will be in the future.)

http://my.webmd.com/content/Article/90/100818.htm?printing=true
"July 15, 2004 -- Members of a government panel, which
earlier this week recommended more aggressive use of
statin medications for people at the highest risk of
dying from heart disease, failed to disclose financial
links to the companies that make the drugs, according
to a story in the publication Newsday. 

In a Thursday interview with WebMD, the official that
oversaw the panel promised to post the financial
disclosures on the National Heart, Lung, and Blood
Institute's (NHLBI) web site next week. But James
Cleeman, MD, strongly denies that any attempt was made
to keep the public in the dark about the panelists'
financial ties.  Financial information was included
when the panel published its original guidelines in
2001, Cleeman says, so it did not seem necessary to
include it again in the newly updated version. Cleeman
is the coordinator of the NHLBI's National Cholesterol
Education Program (NCEP).  "In our minds this was a
non-issue because financial disclosure is available
(for everyone on the panel)," he says. "However, in
the current climate we understand that it is very
desirable to have things as transparent as possible.
So with that in mind, we are going to put this
information on the NHLBI web site...

"...In the story published Thursday, Newsday reported
that six of the nine panelists serving on the NCEP
committee, which updated the guidelines, disclosed
receiving grants or consulting fees from drug
companies that make cholesterol-lowering drugs in the
2001 report... 

"...The revisions were endorsed by the AHA and the
American College of Cardiology, each of which had a
representative on the panel. Cleeman points out that
the changes were reviewed by the NCEP coordinating
committee and steering bodies of the other two
organizations.  "I would say that more than 90 people
were involved in this review," he says. "Nobody is
quarreling with the substance of the message. I hope
the public will not be diverted from the importance of
taking action to lower their LDL cholesterol by this."


But Curt Furberg, MD, who is a former head of clinical
trials at NHLBI, said he is concerned about the amount
of paid consulting being done by researchers who are
supposed to have the public's best interest in mind. 
"I don't think NHLBI has a good track record of
disclosing conflict of interest," he tells WebMD. 
"Many of these ties to drug companies are too close
for comfort. There is just too much spin these days in
the interpretation of research, and the spin has
financial overtones." 

Every study/paper published in reputable medical
journals is supposed to include any financial ties of
the authors to the makers of the subject drug/device;
I think it's quite reasonable for the same standards
to be applied to guidelines that affect millions of
people.

Debbi


                
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