Anticipating the evolution of clinical cholesterol guidelines: implications of recent statin intervention trials

Over the past two decades, statin-based intervention trials have conclusively shown that lowering low-density lipoprotein cholesterol (LDL-C) prevents cardiovascular disease and death. In response to these trials, the National Cholesterol Education Program has established and refined LDL-C goals in its Adult Treatment Panel (ATP) guidelines. In response to five new statin trials, the 2004 update to ATP III called for more aggressive lowering of LDL-C. Subsequent to the ATP III update, three large-scale statin trials have been published with implications for the management of cholesterol. Review of these recent trials indicates that improved methods of risk stratification and intensification of LDL-C goals are trends which are likely to continue into the future.