| Redefining normal low-density lipoprotein cholesterol: a strategy to unseat coronary disease as the nation's leading killer. | |
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MedLine Citation:
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PMID: 20705220 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The new Adult Treatment Panel guidelines will be published in 2011. This paper suggests the consideration of major changes in the existing management guidelines for low-density lipoprotein cholesterol management based on 2 fundamental principles: return the low-density lipoprotein cholesterol level to the normal range and begin treatment closer to disease onset. These principles suggest the value of rethinking all 3 of the principal features of the Adult Treatment Panel III guidelines for low-density lipoprotein cholesterol management: the initiation criteria, the use of variable targets, and the level of the treatment target. Because the principal issue surrounding guideline change is likely to be uncertainty concerning cost and toxicity, the text of new guidelines would have to completely satisfy this concern by strong emphasis on a prudent conservative approach to implementation and would include both cautionary data and caveats concerning the tradeoffs between the potency, cost, and toxicity of statins. The proposed changes in the guidelines, if combined with effective implementation, would likely lead to the displacement of atherosclerotic disease as the nation's number 1 killer. This review provides a logical rationale and discusses the pros and cons for each of the proposed changes. |
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Authors:
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James S Forrester |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 56 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-13 Completed Date: 2010-09-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 630-6 Citation Subset: AIM; IM |
Copyright Information:
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Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiology, The Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Cardiology, Los Angeles, California 90265-4911, USA. barbmd@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Animals Cholesterol, LDL / blood* Coronary Artery Disease / prevention & control, ultrasonography Coronary Disease / blood, prevention & control* Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use Male Practice Guidelines as Topic Reference Values Risk Assessment Risk Factors Ultrasonography, Interventional |
| Chemical | |
Reg. No./Substance:
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0/Cholesterol, LDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2010 Aug 17;56(8):637-40
[PMID:
20705221
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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