PPRNet Practice Guidelines

Lipid Management

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Practice guidelines:

• Cholesterol screening (total and HDL) in all patients >=18 years of age every 5 years

• LDL-cholesterol measurement yearly in patients with coronary heart disease or other atherosclerotic disease

• LDL-cholesterol control < 100 mg/dl in coronary heart disease or other atherosclerotic disease
  

• Non-HDL cholesterol < 130 mg/dl when triglycerides are between 200 and 499 mg/dl in adults

• Lipid lowering prescription for patients with coronary heart disease or other atherosclerotic disease

Recent clinical trials demonstrate that low-density lipoprotein-lowering therapy reduces total mortality, coronary mortality, major coronary events, coronary artery procedures, and stroke in persons with established coronary heart disease. A low-density lipoprotein cholesterol level of <100 mg/dL is optimal; therefore, the Adult Treatment Panel III specifies a low-density lipoprotein cholesterol <100 mg/dL as the goal of therapy in secondary prevention. The same goal should apply for persons with coronary heart disease risk equivalents of symptomatic carotid artery disease, peripheral arterial disease, abdominal aortic aneurysm and diabetes mellitus.  The 2004 Update to the Adult Treatment Panel III recommendations provide an optional LDL-cholesterol goal of <70 mg/dl in very high risk patients.  Very high risk patients are defined as those with multiple major risk factors (including diabetes mellitus), history of acute coronary syndrome, or multiple components of the metabolic syndrome.

Additional resources: 

Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Full Report and 2004 Update

(ATP III] , [ATP III 10 Year Risk Calculator]