Document Detail


Redefining normal low-density lipoprotein cholesterol: a strategy to unseat coronary disease as the nation's leading killer.
MedLine Citation:
PMID:  20705220     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
James S Forrester
Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2010-08-13     Completed Date:  2010-09-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  630-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, The Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Cardiology, Los Angeles, California 90265-4911, USA. barbmd@gmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
0/Cholesterol, LDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2010 Aug 17;56(8):637-40   [PMID:  20705221 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Earlier Intervention in the Management of Hypercholesterolemia What Are We Waiting For?
Next Document:  Imaging of Vascular Inflammation With [(11)C]-PK11195 and Positron Emission Tomography/Computed Tomo...