Cholesterol and coronary heart disease prevention--a transatlantic consensus

Recent research findings have enhanced interest in coronary heart disease prevention. Three expert panels, one in the United States and two in Europe, have addressed the subject and recommended appropriate action. The report of the United States Consensus Conference on Lowering Blood Cholesterol appeared in 1985, and the reports of the European Atherosclerosis Society and British Cardiac Society appeared in 1987. We discuss these reports and emphasize the proposals concerning cholesterol. We review the scientific background to the decisions of the expert panels, high-risk and population-based strategies, cholesterol screening and cholesterol reference levels for the initiation of treatment and therapeutic goals. Dietary recommendations are highlighted and the attention given to special groups such as women, the elderly and children is appraised. Finally, the recommendations of the reports regarding the other risk factors are discussed. We note the general consensus among them and outline the strategies and guidelines which advocate concerted effort to reduce the burden of coronary heart disease.