People at risk of coronary heart disease should not be denied treatment with effective drugs for purely financial reasons.

Editor--As soon as effective treatments for coronary heart disease--which causes 30% of deaths in the United Kingdom--became available, evidence based medicine and finance clashed. The Standing Medical Advisory Committee attempted to impose the Sheffield risk tables[1] and was condemned for its simplistic guidelines and high threshold for treatment.[2] A report on cholesterol and heart disease by the NHS Centre for Reviews and Dissemination now seeks to reduce expenditure on statins by focusing clinical effort on modification of lifestyle and treatment for mild hypertension.[3]

The relation between cholesterol and coronary heart disease is log-linear so a "normal" …