In 1986, an ad hoc committee of the National Heart, Lung, and Blood Institute's Atherosclerosis, Hypertension, and Lipid Metabolism Advisory Committee (AHLMAC) recommended a randomized clinical trial of cholesterol-lowering using an HMG CoA reductase inhibitor in the elderly. The recommendation was endorsed by the full AHLMAC and approved by the National Heart, Lung, and Blood Advisory Council (NHLBAC) in May 1987. However, due to the high cost of such a trial and concerns about feasibility, an initiative for a two-year pilot study at five clinical centers was developed and approved by the NHLBAC in September 1988. The Request for Applications was released in February 1989 and awards made in July 1990.