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Guidelines may boost cholesterol intervention for more patients

Effective treatments are available, but physician and patient adherence remains a challenge.

By Victoria Stagg Elliott, amednews staff. March 12, 2001.

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New government guidelines outlining the means for detecting, evaluating and treating high blood cholesterol will expand recommendations for intervention to an increasing number of patients, according to cholesterol experts who have seen drafts of the report. Included in the new guidelines are patients with normal cholesterol levels who exhibit other factors that put them at high risk for heart disease, such as diabetes.

"[The recommendations] will include more people for more aggressive therapy, people with multiple risk factors whose risk adds up to something," said Paul Ziajka, MD, PhD, director of the Florida Lipid Institute in Orlando.

These updated recommendations by the Adult Treatment Panel of the National Cholesterol Education Program at the National Heart, Lung and Blood Institute are expected in May. They were last revised in 1993. Since then, mortality from heart disease has declined but still remains the No. 1 killer in the United States.

"The 1993 guidelines were remarkably forward looking," said James Cleeman, MD, coordinator of the cholesterol education program at the NHLBI. "But there have been quite a lot of trials since 1993 and we have a lot of new information."

The new guidelines are expected to address new information on differing cardiovascular risk factors between men and women and among different ethnic groups, screening recommendations for young adults and new targets for LDL cholesterol levels in patients who already have heart disease. They also likely will include treatments that address high triglycerides, the significance of nutrition in treatment and prevention and whether HDL -- so-called "good cholesterol" -- should be a target of therapy. [...]