New National Guidelines On Managing Cholesterol Supported

DANBURY — New guidelines from the National Cholesterol Education Program (NCEP) of the National Heart, Lung and Blood Institute on more aggressive management and prevention of high cholesterol are being strongly supported by David Copen, MD, chief of cardiology at Danbury Hospital.

The guidelines released in May by NCEP, part of the National Institute of Health (NIH), are more rigorous than in the past, suggesting that more people than previously thought should be on cholesterol-lowering medication. Dr Copen believes that these recommendations will help doctors save more lives and prevent heart attacks, bypass graft surgery, and angioplasty.

The first major update in guidelines in nearly a decade increases the number of Americans who are candidates for cholesterol lowering drugs to about 36 million from under the old guidelines, according to Dr Copen.

“Previously, we only gave medication to patients who had well documented heart disease and were extremely high risk to develop coronary disease,” he said. “Now, we’re targeting a population that has never had a heart attack. In the past, we usually advised those people about diet and exercise. New recommendations suggest that more patients be given drugs from the start.

Key changes in the guidelines also will help doctors better identify those at high risk of heart attack. Guidelines also include use of a lipoprotein profile as the first test for high cholesterol, a new level at which low HDL (high-density lipoprotein) becomes a major heart disease risk factor, a new set of therapeutic lifestyle changes with more power to improve cholesterol levels, a sharper focus on a cluster of heart disease risk factors known as the metabolic syndrome, and increased attention to the treatment of high triglycerides.