[When should hypercholesterolemia patients be diagnosed and treated?]

All prospective epidemiological studies have shown a negative correlation between blood cholesterol level on entering the study and survival in the following years. The same studies have also shown that for a middle-aged man who does not smoke and is neither hypertensive nor diabetic the probability of developing an acute coronary accident increases exponentially with his initial blood cholesterol level. Finally, recent primary prevention studies have provided experimental evidence of the causative role played by hypercholesterolaemia in the genesis of atherosclerosis; they have also led to the conclusion that the reduction of coronary diseases is mainly due to a decrease in blood cholesterol, irrespective of whether this decrease is obtained by diet or drugs. The need for detection and treatment of hypercholesterolaemia therefore is generally accepted. What remains open to discussion and has been the subject of recent consensus conferences is the modalities of detection and the level of blood cholesterol at which diets and drugs should be prescribed.