The reductions in serum LDL cholesterol and in cardiovascular risk were similar in magnitude to those observed in trials comparing statin therapy to a control regimen. The absolute benefit of therapy was defined chiefly by an individual s absolute risk of death due to coronary occlusion.458 Appropriate treatment goals for patients with SIHD have been informed by several trials of intensive lipid-lowering therapy. The HPS (Heart Protection Study) compared simvastatin 40 mg daily to placebo in patients with IHD, other occlusive vascular dis- ease, or diabetes mellitus. On-treatment LDL cholesterol levels averaged 88 mg/dL in those allocated to simvastatin and 127 mg/dL in those randomized to placebo. A consistent and early benefit of therapy was demonstrated, with a 13% reduction in mortality rate and an 18% reduction in coronary death rate.398 Similar reductions in RR were observed regard- less of baseline levels of LDL cholesterol, including in those with initial levels ,116 mg/dL or ,97 mg/dL. (Of note, LDL cholesterol levels in the HPS were not drawn with patients in the fasting state and were measured values rather than the calculated values used in clinical practice and in most trials; measured LDL cholesterol is generally about 15% higher than calculated LDL cholesterol.)398 In the TNT (Treating to New Targets) trial, patients with clinically apparent IHD and LDL cholesterol .130 mg/dL were randomly assigned to either 10 mg or 80 mg of atorvastatin per day. The mean LDL cholesterols were 77 mg/dL during treatment with 80 mg of atorvastatin and 101 mg/dL during treatment with 10 mg of atorvastatin. 