CHD risk equivalents and the metabolic syndrome. Trial evidence supports aggressive management.
Updated guidelines issued by the National Cholesterol Education Program's 2001 Adult Treatment Panel III (ATP III) reaffirm the importance of intensive management of low density lipoprotein cholesterol (LDL-C) in patients with established coronary heart disease (CHD). Clinical studies also show that diabetes, peripheral arterial disease, abdominal aortic aneurysm, and symptomatic carotid artery disease are CHD risk equivalents that require intensive therapeutic lifestyle changes and drug therapy to prevent associated morbidity and mortality. Likewise, the metabolic syndrome is a secondary target of treatment. Drug therapy usually starts with an LDL-C-lowering agent, such as a statin. If LDL-C and non-high-density lipoprotein cholesterol goals are not achieved, statin therapy should be intensified or a fibrate or niacin should be added.
Thompson
Paul D
PD
Preventive Cardiology and Cardiovascular Research, Hartford Hospital, Hartford, CT 06102, USA. pthomps@harthosp.org
D000328:Adult; D008078:Cholesterol, LDL / Q000097:blood*; D002995:Clofibric Acid / Q000008:administration & dosage; D003327:Coronary Disease / Q000517:prevention & control*; D048909:Diabetes Complications / Q000188:drug therapy; D050171:Dyslipidemias / Q000188:drug therapy; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000188:drug therapy*; D009525:Niacin / Q000008:administration & dosage
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D009525:Niacin; D002995:Clofibric Acid