So the key conclusion from the study is that the intervention, based on the hypothesis that the reversal of coronary risk factors must reduce deaths from CHD and, as a result, also from all causes, produced the opposite result. The intervention caused harm.
The authors could only suggest that “these unexpected results may not question multifactorial prevention as such” (61, p. 1225) — except, of course, in the process of normal science, these findings should most definitely raise questions about whether we should be forcing well-intended interventions on patients to reverse their “risk factors” when the outcome may be harmful to their health.