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The National Cholesterol Education Program Adult Treatment Panel III guidelines
1Health Net of Arizona, 930 North Finance Center Dr., Tucson, Arizona 85710, USA. Robert.J.Lipsy@az.health.net
Insights
Coronary heart disease (CHD) is a leading cause of death. New guidelines emphasize lowering low-density lipoprotein cholesterol (LDL-C) for better risk assessment and treatment eligibility.
Area of Science:
- Cardiology
- Public Health
- Metabolic Disorders
Background:
- Coronary heart disease (CHD) is a primary cause of mortality in the U.S.
- Dyslipidemia is a significant risk factor for CHD development and progression.
- Cholesterol modification offers public health and economic advantages.
Purpose of the Study:
- To outline the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) guidelines.
- To highlight updated recommendations for detecting, evaluating, and treating high cholesterol.
- To emphasize risk assessment and LDL-C reduction for CHD management.
Main Methods:
- Review and synthesis of existing clinical trial data on cholesterol modification.
- Development of updated guidelines based on NCEP recommendations.
- Inclusion of new features such as CHD risk equivalents and metabolic syndrome emphasis.
Main Results:
- The ATP III guidelines were released in May 2001.
- New guidelines identify CHD risk equivalents and lower treatment targets.
- A risk scoring system is introduced to calculate CHD risk.
Conclusions:
- The ATP III guidelines underscore the importance of low-density lipoprotein cholesterol (LDL-C) reduction.
- Emphasis on risk assessment will increase the number of patients identified as at risk for CHD.
- More patients will become eligible for lifestyle and drug interventions to manage cholesterol and reduce CHD risk.
Abstract:
Coronary heart disease (CHD) persists as a major cause of morbidity and mortality in the United States, with more than 40% of all deaths each year directly attributed to the disease. Dyslipidemia is recognized as a major risk factor for the development and progression of CHD, with clinical trials clearly demonstrating the public health and economic benefits of favorable cholesterol modification. As a result of this evidence, the National Cholesterol Education Program (NCEP) has developed guidelines for the detection, evaluation, and treatment of high blood cholesterol in adults. The most recent of the NCEP recommendations, the Adult Treatment Panel III (ATP III) guidelines, were released in May 2001 and build on the earlier editions and reiterate the importance of low-density lipoprotein cholesterol (LDL-C) reduction to modify CHD risk. New features of the guidelines include the identification of CHD risk equivalents; lower treatment target goals; an emphasis on conditions conferring a higher risk for CHD, such as the metabolic syndrome; and a scoring system for calculating CHD risk. The ATP III emphasis on risk assessment will result in a substantial increase in the number of patients considered at risk for CHD and will expand the number eligible for lifestyle and drug intervention.
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