Cholesterol Guidelines Update

The National Cholesterol Education Program (NCEP), with the endorsement of the National Heart, Lung, and Blood Institute (NHLBI), the American College of Cardiology, and the American Heart Association, has just issued new recommendations concerning LDL cholesterol levels for people at risk for cardiovascular disease (CVD).

LDL is referred to as "bad" cholesterol. High levels of "bad" cholesterol lead to buildup of cholesterol in the lining of the blood vessels; this increases a person's chances of developing heart disease. Recently published medical studies provide new information on the benefits of reducing LDL to lower levels than had been previously recommended for individuals with very high, high, or moderately high risk for CVD. Making the right therapeutic lifestyle changes (intensive use of nutrition, physical activity, and weight control) is also recommended for lowering LDL. The following chart defines the patient categories, the 2001 Adult Treatment Panel (ATP III) guidelines and the new therapeutic options recommended for each.

Category Definition Therapeutic Option ATP III Goal Very high-risk Have cardiovascular disease together with either multiple risk factors (especially diabetes), or severe and poorly controlled risk factors (e.g., continued smoking), or metabolic syndrome (a constellation of risk factors associated with obesity including high triglycerides and low HDL). Patients hospitalized for acute coronary syndromes such as heart attack are also at very high risk. <70 mg/dL option to use drug therapy to reach the less than 70 mg/dL goal <100 mg/dL High-risk Have coronary heart disease or disease of the blood vessels to the brain or extremities, or diabetes, or multiple (2 or more) risk factors (e.g., smoking, hypertension) that give them a greater than 20 percent chance of having a heart attack within 10 years. <100 mg/dL recommends drug therapy for patients whose LDL is 100 to 129 mg/dL <130mg/dL Moderately high-risk Those who have multiple (2 or more) risk factors for coronary heart disease together with a 10 to 20 percent risk of heart attack within 10 years <100 mg/dL recommends drug therapy at LDL levels of 100 - 129 mg/dL <130mg/dL

Talk to your health care provider about the medical treatment and lifestyle change plan that is best for you. "Lifestyle changes continue to be an essential part of controlling cholesterol. Therapeutic Lifestyle Change (TLC) has the potential to reduce cardiovascular risk through several mechanisms beyond LDL lowering," said Scott Grundy, M.D., director of the Center for Human Nutrition at the University of Texas Southwestern Medical Center at Dallas and chair of the NCEP working group that developed the update report.

For more information:
What is Cholesterol and How to Manage It
To calculate your 5 and 10 year heart attack risk, go to: Framingham Calculator
To learn more about the cholesterol-heart disease connection, go to: What does cholesterol have to do with heart disease?
To read the news release on the new guidelines, go to: Update on Cholesterol Guidelines: More-Intensive Treatment Options for Higher Risk Patients

Source: This HOOAH News Flash was reviewed by: LTC Hart, CHN, DHPW; MAJ Danny Jaghab, RD, DHPW; Dr. Colleen Weese, MD, DOEM; Lisa J. Young, MS, CHES USACHPPM-DHPW; approved by HIO, and released by the USACHPPM Public Information Office on July 22, 2004. Author: Ms. Judith S. Harris, H4H Consultant, CHES, MSN.