Overall, these results from clinical practice verify a recent meta-analysis of published randomized clinical trials, showing that the different lipid lowering agents are equally efficacious at comparable doses. A possible contributory cause for the results of this study could be the on-going discussion on the value of reaching certain treatment lipid goals vs. standardized treatment with statins in risk groups of patients, which could affect the prescribers. Major clinical trials such as the Heart Protection Study and the Collaborative Atorvastatin Diabetes Study, underscored by the results of the recent meta-analysis RSV604 have shown secondary preventive risk reduction after statin treatment also in patients without pronounced hypercholesterolaemia. In order to reduce CVD risk, however, the current US guidelines promote statin use in patients with diabetes and overt CVD, or in patients without CVD who are older than 40 years and have one or more CVD risk factors. Alternatively, a reduction in LDL-C of 30–40% could be aimed at in patients not satisfactorily responding to a maximal dose of statin. The European guidelines similarly promote LDL-C,2.5 mmol/L as the general treatment target in patients with type 2 diabetes or type 1 diabetes with nephropathy, but also give an opportunity for the clinician to offer statins in patients with LDL-C,2.6 mmol/L. The NDR has currently an estimated coverage of all patients in hospital outpatient clinics and more than HPB of all patients in primary care. The patients included in this study are selected only based on completeness of the analysed data, suggesting that they are indeed representative. There might be minor errors in the clinical characteristics and risk factor values from clinics where these are reported manually, but more and more clinics transfer data automatically from computerized medical records systems. There were, however, some expected differences in mean levels and proportions of risk factors in the different treatment groups, suggesting possible selection effects. Therefore the results regarding blood lipid levels as well as the LDL-C lowering effects of the different treatments should be interpreted with some caution and should ideally be confirmed in prospective clinical trials.