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Latest Cholesterol Guidelines

NCEP ATP III cholesterol recommendations

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Updated November 16, 2013

NOTE: This article is now out of date.  The cholesterol treatment guidelines were changed fairly drastically on November 12, 2013.  You can read about the REAL latest cholesterol guidelines here.

 

The last full report from the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), making recommendations on the treatment of cholesterol and triglycerides, was published in 2002. An update was published in 2004.

A lot has been learned about cholesterol and triglycerides since 2004, and the medical community has been expecting a new report from the NCEP for several years - it is unclear at this time when a new report will finally be issued.

Current Recommendations on Cholesterol

For high-risk patients (those with a 10-year risk* of a cardiac event of 20%): The LDL cholesterol should be lowered to below 100 mg/dL, and consideration should be given to lowering it to below 70 mg/dL.

For moderately high-risk patients (those with a 10-year risk* of a cardiac event between 10 and 20%): LDL cholesterol should be lowered to below 130 mg/dL, and consideration should be given to lowering it to below 100 mg/dL.

For intermediate-risk patients (those with a 10-year risk* of a cardiac event less than 10%): LDL cholesterol should be lowered to below 130 mg/dL.

For low-risk patients (those with a 10-year risk* of a cardiac event less than 1%): LDL cholesterol should be below 160 mg/dL.

Since these recommendations were published, evidence has suggested that, in at least some individuals, treatment with statins should be considered even if their cholesterol levels are not elevated. Other evidence - suggesting that using certain medications to increase HDL cholesterol levels (the "good" cholesterol) can produce worse outcomes - has called into question the notion that higher HDL levels are always a good thing. For these and other reasons, it is widely believed that new NCEP guidelines are overdue.

However, the current NCEP guidelines, as far as they go, are still considered to be solid, and most doctors try to follow them.

* You can find out how to assess your own 10-year risk of heart disease here.

Sources:

Grundy SM, Cleeman JI, Bairey Merz CN, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004;110:227-239.

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