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Recent National Cholesterol Education Program Adult Treatment Panel III update: adjustments and options.
Am J Cardiol 2005; 96(4A):53E-59EAJ

Abstract

In the summer of 2004, an evidence-based update of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) guidelines for management of hypercholesterolemia was published. This detailed assessment of 5 major clinical trials, published since the ATP III report in 2001, was designed to provide guidance for physicians in decision making for patients at high risk and very high risk. We have tried to summarize this assessment by suggesting the following to clinicians: (1) Calculate global risk of coronary artery disease (CAD) to determine an overall strategy for cholesterol management. (2) Emphasize the benefits of diet, exercise, and weight control or therapeutic lifestyle change, especially in those with lifestyle risk factors. (3) Use 3-hydroxy-3-methyglutaryl coenzyme A reductase inhibitors (statins) as first-line drugs to reduce risk of CAD and stroke in those at moderate to high risk. (4) If statins are prescribed, use moderate doses that reduce plasma levels of low-density lipoprotein (LDL) cholesterol by > or = 30% to 40%. (5) Strongly consider statin therapy in those with diabetes (with the exception of severe hypertriglyceridemia). (6) Consider LDL cholesterol-lowering drug therapy for lipids in older patients at risk. (7) Consider adding either a fibrate or nicotinic acid in high-risk patients with elevated plasma triglyceride values or low levels of plasma high-density lipoprotein cholesterol after statin therapy has achieved the LDL cholesterol goal. (8) Continue to treat those at low risk in similar fashion as before. This update is to inform current physician judgment in this area. Further clinical trial data that may modify or extend these recommendations are eagerly awaited.

Authors+Show Affiliations

Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. n-stone@northwestern.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16098845

Citation

Stone, Neil J., et al. "Recent National Cholesterol Education Program Adult Treatment Panel III Update: Adjustments and Options." The American Journal of Cardiology, vol. 96, no. 4A, 2005, pp. 53E-59E.
Stone NJ, Bilek S, Rosenbaum S. Recent National Cholesterol Education Program Adult Treatment Panel III update: adjustments and options. Am J Cardiol. 2005;96(4A):53E-59E.
Stone, N. J., Bilek, S., & Rosenbaum, S. (2005). Recent National Cholesterol Education Program Adult Treatment Panel III update: adjustments and options. The American Journal of Cardiology, 96(4A), pp. 53E-59E.
Stone NJ, Bilek S, Rosenbaum S. Recent National Cholesterol Education Program Adult Treatment Panel III Update: Adjustments and Options. Am J Cardiol. 2005 Aug 22;96(4A):53E-59E. PubMed PMID: 16098845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recent National Cholesterol Education Program Adult Treatment Panel III update: adjustments and options. AU - Stone,Neil J, AU - Bilek,Sarah, AU - Rosenbaum,Sara, PY - 2005/8/16/pubmed PY - 2005/9/30/medline PY - 2005/8/16/entrez SP - 53E EP - 59E JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 96 IS - 4A N2 - In the summer of 2004, an evidence-based update of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) guidelines for management of hypercholesterolemia was published. This detailed assessment of 5 major clinical trials, published since the ATP III report in 2001, was designed to provide guidance for physicians in decision making for patients at high risk and very high risk. We have tried to summarize this assessment by suggesting the following to clinicians: (1) Calculate global risk of coronary artery disease (CAD) to determine an overall strategy for cholesterol management. (2) Emphasize the benefits of diet, exercise, and weight control or therapeutic lifestyle change, especially in those with lifestyle risk factors. (3) Use 3-hydroxy-3-methyglutaryl coenzyme A reductase inhibitors (statins) as first-line drugs to reduce risk of CAD and stroke in those at moderate to high risk. (4) If statins are prescribed, use moderate doses that reduce plasma levels of low-density lipoprotein (LDL) cholesterol by > or = 30% to 40%. (5) Strongly consider statin therapy in those with diabetes (with the exception of severe hypertriglyceridemia). (6) Consider LDL cholesterol-lowering drug therapy for lipids in older patients at risk. (7) Consider adding either a fibrate or nicotinic acid in high-risk patients with elevated plasma triglyceride values or low levels of plasma high-density lipoprotein cholesterol after statin therapy has achieved the LDL cholesterol goal. (8) Continue to treat those at low risk in similar fashion as before. This update is to inform current physician judgment in this area. Further clinical trial data that may modify or extend these recommendations are eagerly awaited. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/16098845/Recent_National_Cholesterol_Education_Program_Adult_Treatment_Panel_III_update:_adjustments_and_options_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(05)00922-7 DB - PRIME DP - Unbound Medicine ER -