For this reason, the Work Group recommends that monitoring lipid levels in patients taking statins be individualized based on ongoing shared decision making between the patient and the provider rather than routine. Table 2. Effect of More Intense Lipid Lowering on CVD Outcomes and Diabetes: A Summary of Recent Meta-analyses Author Setting and Population Intervention/Comparator (either placebo or less intense LDL lowering) Primary Endpoint(s) Relative Risk Absolute Risk Meta- mmol/ L ) Shin et al. RCTs of subjects at risk for stroke LDL lowering by statins or non-statins (versus placebo or less intense LDL lowering) Stroke versus stroke risk CI: 0.7% LDL-C level: 1.3 mmoI/L (50 mg/dL) versus higher levels (control) versus LDL-C level: 1.3 mmoI/L (50 mg/dL) to 1.8 mmoI/L (70 mg/dL) versus higher levels (control) LDL-C level: achieved LDL-C level >1.8 mmoI/L (70 mg/ dL) versus control versus Silverman et al. RCTs of LDL lowering Different statin and non- statin therapies MI, CHD, or CVD death Statins Non-statins Navarese et al. LDL lowering trials with initial low LDL More intensive compared with less intensive LDL-C lowering, stratified by baseline LDL level Total and CVD death versus Sabatine et al. LDL lowering trials with initial low LDL Statins and non-statins CHD death, MI, ischemic CVA, or CABG/PTCA Statins Non-statins Cai et al. 