Abstract
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.
Keywords: statins, low‐density lipoprotein cholesterol, hypercholesterolemia, Adult Treatment Panel III
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