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Update on the National Cholesterol Education Program Adult Treatment Panel III guidelines: getting to goal.
Pharmacotherapy 2003; 23(9 Pt 2):26S-33SP

Abstract

Considerable data on the pathophysiology, epidemiology, and treatment of dyslipidemia-induced coronary heart disease (CHD) have accumulated in recent years. These data have been assessed and incorporated into the guidelines of the National Cholesterol Education Program Expert Panel on the Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel [ATP] III). A major focus of the new guidelines is the assessment of the near-term (i.e., 10-yr) risk of experiencing a CHD event and matching the intensity of treatment to this risk. Patients with diabetes and those with a greater than 20% 10-year risk of experiencing a CHD event have been elevated to the risk level of CHD equivalent. The ATP III guidelines also modify several lipid and lipoprotein classifications. A low-density lipoprotein cholesterol (LDL) level below 100 mg/dl is now considered optimum for all individuals. In addition, high-density lipoprotein cholesterol (HDL) and triglyceride cutoff points have been modified to reflect more accurately the risk associated with abnormalities in these lipoproteins. As with the previous guidelines, the primary target of therapy remains LDL. Therapeutic lifestyle changes consisting of diet, weight reduction, and increased physical activity should be included in all treatment regimens. Based on their potent LDL-lowering properties and their proven ability to decrease mortality in a variety of patient populations, statins are generally the first choice for pharmacologic therapy. A secondary target of therapy includes non-HDL goals for patients with high triglyceride levels and the metabolic syndrome, which is characterized by abdominal obesity, elevated triglyceride levels, low HDL levels, and insulin resistance. Management of these secondary targets includes weight reduction and increased physical activity, and treatment of the lipid and nonlipid risk factors. Overall, ATP III represents an aggressive approach to treating dyslipidemia, greatly extending the number of individuals who qualify for treatment.

Authors+Show Affiliations

National Clinical Research, Inc., Richmond, Virginia 23294, USA. jmckenney@ncrinc.net

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

14524636

Citation

McKenney, James M.. "Update On the National Cholesterol Education Program Adult Treatment Panel III Guidelines: Getting to Goal." Pharmacotherapy, vol. 23, no. 9 Pt 2, 2003, 26S-33S.
McKenney JM. Update on the National Cholesterol Education Program Adult Treatment Panel III guidelines: getting to goal. Pharmacotherapy. 2003;23(9 Pt 2):26S-33S.
McKenney, J. M. (2003). Update on the National Cholesterol Education Program Adult Treatment Panel III guidelines: getting to goal. Pharmacotherapy, 23(9 Pt 2), 26S-33S.
McKenney JM. Update On the National Cholesterol Education Program Adult Treatment Panel III Guidelines: Getting to Goal. Pharmacotherapy. 2003;23(9 Pt 2):26S-33S. PubMed PMID: 14524636.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Update on the National Cholesterol Education Program Adult Treatment Panel III guidelines: getting to goal. A1 - McKenney,James M, PY - 2003/10/4/pubmed PY - 2004/2/6/medline PY - 2003/10/4/entrez SP - 26S EP - 33S JF - Pharmacotherapy JO - Pharmacotherapy VL - 23 IS - 9 Pt 2 N2 - Considerable data on the pathophysiology, epidemiology, and treatment of dyslipidemia-induced coronary heart disease (CHD) have accumulated in recent years. These data have been assessed and incorporated into the guidelines of the National Cholesterol Education Program Expert Panel on the Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel [ATP] III). A major focus of the new guidelines is the assessment of the near-term (i.e., 10-yr) risk of experiencing a CHD event and matching the intensity of treatment to this risk. Patients with diabetes and those with a greater than 20% 10-year risk of experiencing a CHD event have been elevated to the risk level of CHD equivalent. The ATP III guidelines also modify several lipid and lipoprotein classifications. A low-density lipoprotein cholesterol (LDL) level below 100 mg/dl is now considered optimum for all individuals. In addition, high-density lipoprotein cholesterol (HDL) and triglyceride cutoff points have been modified to reflect more accurately the risk associated with abnormalities in these lipoproteins. As with the previous guidelines, the primary target of therapy remains LDL. Therapeutic lifestyle changes consisting of diet, weight reduction, and increased physical activity should be included in all treatment regimens. Based on their potent LDL-lowering properties and their proven ability to decrease mortality in a variety of patient populations, statins are generally the first choice for pharmacologic therapy. A secondary target of therapy includes non-HDL goals for patients with high triglyceride levels and the metabolic syndrome, which is characterized by abdominal obesity, elevated triglyceride levels, low HDL levels, and insulin resistance. Management of these secondary targets includes weight reduction and increased physical activity, and treatment of the lipid and nonlipid risk factors. Overall, ATP III represents an aggressive approach to treating dyslipidemia, greatly extending the number of individuals who qualify for treatment. SN - 0277-0008 UR - https://www.unboundmedicine.com/medline/citation/14524636/Update_on_the_National_Cholesterol_Education_Program_Adult_Treatment_Panel_III_guidelines:_getting_to_goal_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0277-0008&date=2003&volume=23&issue=9 Pt 2&spage=26S DB - PRIME DP - Unbound Medicine ER -