Critical appraisal of revised cholesterol guidelines for the very high-risk patient.
A working group from the Adult Treatment Panel III of the national Cholesterol Educational Program issued a revised algorithm for low-density lipoprotein (LDL)-cholesterol lowering in very high-risk cardiovascular disease patients. The rationale of these recommendations was primarily established from pooled analysis of multiple clinical trials of LDL-cholesterol-lowering therapies and limited data from an acute coronary syndrome trial. In the near future, the findings of these large-scale randomized trials designed to test the hypothesis that more aggressive LDL-cholesterol therapy is accompanied by fewer cardiovascular events than less aggressive LDL-cholesterol lowering therapy, will provide the evidence needed to support or refute these new recommendations. In this article, the authors suggest that an LDL-cholesterol level of less than 70 mg/dl is unattainable and not necessary for many high-risk patients. Furthermore, the potential risks associated with high-dose statin agents in certain patients, such as the elderly, may outweigh these putative benefits.[1]References
- Critical appraisal of revised cholesterol guidelines for the very high-risk patient. Rosenson, R., Lloyd-Jones, D. Expert review of cardiovascular therapy. (2005) [Pubmed]
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