title: Waiting for the National Cholesterol Education Program Adult Treatment Panel IV Guidelines, and in the meantime, some challenges and recommendations.
abstract: The National Cholesterol Education Program Adult Treatment Panel (ATP) has provided education and guidance for decades on the management of hypercholesterolemia. Its third report (ATP III) was published 10 years ago, with a white paper update in 2004. There is a need for translation of more recent evidence into a revised guideline. To help address the significant challenges facing the ATP IV writing group, this statement aims to provide balanced recommendations that build on ATP III. The authors aim for simplicity to increase the likelihood of implementation in clinical practice. To move from ATP III to ATP IV, the authors recommend the following: (1) assess risk more accurately, (2) simplify the starting algorithm, (3) prioritize statin therapy, (4) relax the follow-up interval for repeat lipid testing, (5) designate <70 mg/dl as an "ideal" low-density lipoprotein cholesterol target, (6) endorse targets beyond low-density lipoprotein cholesterol, (7) refine therapeutic target levels to the equivalent population percentile, (8) remove misleading descriptors such as "borderline high," and (9) make lifestyle messages simpler. In conclusion, the solutions offered in this statement represent ways to translate the totality of published reports into enhanced hyperlipidemia guidelines to better combat the devastating impact of hyperlipidemia on cardiovascular health.
authors.forename: Seth S
authors.initials: SS
authors.lastname: Martin
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Metkus
authors.forename: Aaron
authors.initials: A
authors.lastname: Horne
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.forename: Rani
authors.initials: R
authors.lastname: Hasan
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Campbell
authors.forename: Omair
authors.initials: O
authors.lastname: Yousuf
authors.forename: Parag
authors.initials: P
authors.lastname: Joshi
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kaul
authors.forename: Michael
authors.initials: M
authors.lastname: Miller
authors.forename: Erin D
authors.initials: ED
authors.lastname: Michos
authors.forename: Steven R
authors.initials: SR
authors.lastname: Jones
authors.forename: Ty J
authors.initials: TJ
authors.lastname: Gluckman
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Cannon
authors.forename: Laurence S
authors.initials: LS
authors.lastname: Sperling
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
mesh_terms: D000328:Adult; D000465:Algorithms; D001053:Apolipoproteins / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000097:blood / Q000628:therapy*; D008019:Life Style; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D009626:Terminology as Topic; D014481:United States
chemical_list: D001053:Apolipoproteins; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors