New features of the National Cholesterol Education Program Adult Treatment Panel III lipid-lowering guidelines

被引:30
作者
Brewer, HB [1 ]
机构
[1] NHLBI, Mol Dis Branch, NIH, Bethesda, MD 20814 USA
关键词
statins; low-density lipoprotein cholesterol; hypercholesterolemia; Adult Treatment Panel III;
D O I
10.1002/clc.4960261505
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) guidelines for lipid-lowering therapy to reduce coronary heart disease (CHD) risk contain a number of features that distinguish them from the previous ATP guidelines. These new features include modifications in lipid/lipoprotein levels considered optimal, abnormal, or reflective of risk; increased focus on primary prevention through use of Framingham risk scoring to define risk in persons with multiple lipid/nonlipid risk factors; and increased focus on the association of the metabolic syndrome with CHD risk. The introduction of the category of CHD risk equivalents-including persons with atherosclerotic disease, diabetes, or 10-year CHD risk > 20% based on Framingham scoring-results in an increase over previous guidelines in the proportion of patients categorized as being at high risk and therefore eligible for more intensive low-density lipoprotein cholesterol (LDL-C)-lowering therapy. Use of the new secondary therapeutic target of non-high-density lipoprotein cholesterol should improve management of lipid risk factors in patients who have elevated triglyceride levels after LDL-C goals have been met. These new features of the NCEP ATP III guidelines should improve identification and treatment of patients with dyslipidemias associated with CHD risk.
引用
收藏
页码:19 / 24
页数:6
相关论文
共 15 条
[1]  
Assmann G, 1998, EUR HEART J, V19, pA2
[2]   Correlation of non-high-density lipoprotein cholesterol with apolipoprotein B: Effect of 5 hydroxymethylglutaryl coenzyme a reductase inhibitors on non-high-density lipoprotein cholesterol levels [J].
Ballantyne, CM ;
Andrews, TC ;
Hsia, JA ;
Kramer, JH ;
Shear, C .
AMERICAN JOURNAL OF CARDIOLOGY, 2001, 88 (03) :265-269
[3]  
Brewer HB, 1999, AM J CARDIOL, V83, p3F
[4]   Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) [J].
Cleeman, JI ;
Grundy, SM ;
Becker, D ;
Clark, LT ;
Cooper, RS ;
Denke, MA ;
Howard, WJ ;
Hunninghake, DB ;
Illingworth, DR ;
Luepker, RV ;
McBride, P ;
McKenney, JM ;
Pasternak, RC ;
Stone, NJ ;
Van Horn, L ;
Brewer, HB ;
Ernst, ND ;
Gordon, D ;
Levy, D ;
Rifkind, B ;
Rossouw, JE ;
Savage, P ;
Haffner, SM ;
Orloff, DG ;
Proschan, MA ;
Schwartz, JS ;
Sempos, CT ;
Shero, ST ;
Murray, EZ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (19) :2486-2497
[5]  
Collins R, 2002, LANCET, V360, P7, DOI 10.1016/S0140-6736(02)09327-3
[6]   Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels - Results of AFCAPS/TexCAPS [J].
Downs, JR ;
Clearfield, M ;
Weis, S ;
Whitney, E ;
Shapiro, DR ;
Beere, PA ;
Langendorfer, A ;
Stein, EA ;
Kruyer, W ;
Gotto, AM .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 279 (20) :1615-1622
[7]   New National Cholesterol Education Program III guidelines for primary prevention lipid-lowering drug therapy - Projected impact on the size, sex, and age distribution of the treatment-eligible population [J].
Fedder, DO ;
Koro, CE ;
L'Italien, GJ .
CIRCULATION, 2002, 105 (02) :152-156
[8]   Prevalence of the metabolic syndrome among US adults - Findings from the Third National Health and Nutrition Examination Survey [J].
Ford, ES ;
Giles, WH ;
Dietz, WH .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 287 (03) :356-359
[9]   Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction [J].
Haffner, SM ;
Lehto, S ;
Rönnemaa, T ;
Pyörälä, K ;
Laakso, M .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (04) :229-234
[10]  
PEDERSEN TR, 1994, LANCET, V344, P1383