Advertisement

Management of persons with high risk of coronary heart disease but low serum low-density lipoprotein cholesterol

      Results of the Heart Protection Study
      Heart Protection Study Collaborative Group
      MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals a randomized placebo-controlled trial.
      suggest that lipid-modifying drug therapy should be initiated in patients with coronary heart disease (CHD) or CHD risk equivalents whose low-density lipoprotein (LDL) cholesterol is below the National Cholesterol Education Program Adult Treatment Panel III (ATP III)
      Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
      Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).
      cut-point of 3.36 mmol/L (130 mg/dl), those with LDL cholesterol of 2.59 to 3.35 mmol/L (100 to 129 mg/dl), for whom drug therapy is optional in the guidelines, and those with LDL cholesterol <2.59 mmol/L (100 mg/dl) who are not considered for drug therapy by the guidelines. We analyzed data from the third National Health and Nutrition Examination Survey (NHANES III, 1988 to 1994) to estimate the additional number of United States adults who may benefit from lipid-modifying drug therapy based on the findings of recent statin trials.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Heart Protection Study Collaborative Group
        MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals.
        Lancet. 2002; 360: 7-22
        • Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
        Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).
        JAMA. 2001; 285: 2486-2497
      1. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Health Statistics. Plan and Operation of the Third National Health and Nutrition Examination Survey, 1988–94. Hyattsville, MD: U.S. Department of Health and Human Services; 1994

        • Jacobson T.A.
        • Griffiths G.G.
        • Varas C.
        • Gause D.
        • Sung J.C.Y.
        • Ballantyne C.M.
        Impact of evidence-based “clinical judgment” on the number of American adults requiring lipid-lowering drug therapy based on updated NHANES III data.
        Arch Intern Med. 2000; 160: 1361-1369
        • Friedewald W.T.
        • Levy R.I.
        • Fredrickson D.S.
        Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.
        Clin Chem. 1972; 18: 499-502
      2. Mohadjer L, Montaquila J, Waksberg J, Bell B, James P, Flores-Cervantes I, Montes M. National Health and Nutrition Examination Survey III: weighting and estimation methodology: executive summary. Hyattsville, MD: National Center for Health Statistics; February 1996

        • Wood D.
        • De Backer G.
        • Faergeman O.
        • Graham I.
        • Mancia G.
        • Pyörälä K.
        Prevention of coronary heart disease in clinical practice.
        Atherosclerosis. 1998; 140: 199-270
        • Serruys P.W.
        • de Feyter P.
        • Macaya C.
        • Kokott N.
        • Puel J.
        • Vrolix M.
        • Branzi A.
        • Bertolami M.C.
        • Jackson G.
        • Strauss B.
        • Meier B.
        Fluvastatin for prevention of cardiac events following successful first percutaneous coronary intervention.
        JAMA. 2002; 287: 3215-3222
        • Sacks F.M.
        • Tonkin A.M.
        • Shepherd J.
        • Braunwald E.
        • Cobbe S.
        • Hawkins C.M.
        • Keech A.
        • Packard C.
        • Simes J.
        • Byington R.
        • Furberg C.D.
        Effect of pravastatin on coronary disease events in subgroups defined by coronary risk factors.
        Circulation. 2000; 102: 1893-1900
        • Rubins H.B.
        • Robins S.J.
        • Collins D.
        • Fye C.L.
        • Anderson J.W.
        • Elam M.B.
        • Faas F.H.
        • Linares E.
        • Schaefer E.J.
        • Schectman G.
        • Wilt T.J.
        • Wittes J.
        • Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group
        Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol.
        N Engl J Med. 1999; 341: 410-418