General internists continue to find themselves in demand as health care systems focus on longitudinal care of chronic diseases and outpatient preventive services. New information about preventive health will affect practice. Previous studies on the primary prevention of coronary heart disease have shown that lowering cholesterol reduces the incidence of myocardial infarction (MI), but that mortality from noncardiovascular causes might be increased by treatment. In a randomized controlled trial, 6595 Scottish men aged 45 to 64 years with a mean (±SD) plasma cholesterol level of 7.0±0.6 mmol/L (272±23 mg/dL) were assigned to receive high-dose pravastatin sodium or placebo. During the average follow-up period of almost 5 years, the treated patients had a relative risk reduction for nonfatal MI or death from coronary heart disease of 31%. No excess deaths from noncardiovascular causes occurred in the treatment group.1A meta-analysis using pooled data from 4 double-blind atherosclerosis regression trials comparing