American Heart Association media advisory on new guidelines for cholesterol management

The third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III)

The updated recommendations from the Adult Treatment Panel III (ATP III) published in this week’s JAMA include an important new assessment scale and strategies to control elevated cholesterol and other major cardiovascular disease risk factors.

According to the American Heart Association, an estimated 100,870,000 American adults have total blood cholesterol levels of 200 milligrams per deciliter and above. About 40,600,000 of those individuals have levels of 240mg/dl and above, which is considered high. Reducing these levels, first through lifestyle changes and secondly with drug treatment, can have a significant impact in decreasing the death toll of heart disease and stroke.

The American Heart Association applauds the expert panel for recommending a systematic and logical approach to managing individuals with elevated cholesterol and other cardiovascular risk factors and in taking steps to prevent development of disease in healthy individuals. "The panel rightly recognizes that prevention through dietary and lifestyle changes should be a key focus in the new guidelines and that the new risk assessment tool is a first step in this effort," says Ronald Krauss, M.D., an American Heart Association spokesperson and chairman of the association’s new council on Nutrition, Physical Activity and Metabolism.

"Scientific advances have helped us refine our tools for matching the intensity of risk factor status with treatment. The global risk assessment will enable more clinicians to provide better identification of a patient’s risk, and it will set the stage for future research advances.

"A man with a waistline of 40 inches, triglycerides of 180 and high-density lipoprotein of 40 might have sailed through the previous guidelines; but now we will catch that person and provide the lipid management he needs," says Krauss.

"The new guidelines consider a body of new information supporting the value of managing low-density lipoprotein and other risk factors as well as the evaluation of the overall risk factor profile in making health management decisions," he says.

A new focus is the metabolic syndrome X, characterized by a cluster of heart disease risk factors that is aggravated by being overweight. "A stronger emphasis on dietary practice and physical activity is warranted to help deal with this increasingly prevalent condition," says Krauss.

The NCEP panel also recognized the need to educate physicians. "This will be important in getting the full benefit of these guidelines to the public," he says.

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