2022 www.thelancet.com Vol 373 June 13, 2009 In SEAS, 1873 asymptomatic patients with peak aortic jet velocity of 2·5–4·0 m/s were treated for a median follow-up of 52·2 months with placebo or a combination of simvastatin 40 mg plus ezetimibe 10 mg. Although LDL cholesterol concentrations were lower by about 50% in the treated group, no eff ect on need for aortic valve replacement or on progression of aortic stenosis was achieved. The SEAS study confi rms results from the fi rst smaller randomised clinical trial in this fi eld: the SALTIRE study. The neutral results from both studies provide strong evidence against a favourable eff ect of lipid lowering on aortic stenosis progression and events, despite the fact that lipid lowering in SEAS showed signifi cant benefi cial eff ects on ischaemic events. We conclude that, although retrospec tive studies show a benefi cial eff ect of cholesterol-lowering treatment on the course of aortic stenosis, this fi nding is not confi rmed in the randomised trials published to date.