Converting clinical lipid trials into the practical management of high-risk patients: New NCEP thoughts on treating CHD patients

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Abstract

The National Cholesterol Education Program (NCEP) guidelines published in 1993 made low-density lipoprotein cholesterol (LDL-C) the primary target of intervention. This decision was based on observations in familial hypercholesterolemia and on data from primary, secondary, and angiographic trials conducted prior to 1993. NCEP set the target goal for LDL-C as 100 mg/dL or less for secondary prevention and 130 mg/dL or less for primary prevention. Large-scale, well-designed, cholesterol-lowering trials conducted since 1993 substantiate these goal levels. In particular, the Scandinavian Simvastatin Survival Study and the Cholesterol and Recurrent Events trial showed that LDL-cholesterol-lowering with HMG-CoA reductase inhibitors (statins) reduced coronary events, coronary deaths, and total mortality in patients who had established coronary heart disease (CHD) with both elevated and normal cholesterol levels. These data, together with the NCEP guidelines, underscore the need for aggressive lipid-lowering therapy in patients at risk for CHD.

Original languageEnglish (US)
JournalAmerican Journal of Managed Care
Volume3
Issue numberMAR
StatePublished - 1997

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Risk Management
heart disease
Coronary Disease
Cholesterol
Clinical Trials
Lipids
Education
LDL Cholesterol
Hydroxymethylglutaryl-CoA Reductase Inhibitors
management
education
event
Guidelines
mortality
Hyperlipoproteinemia Type II
Simvastatin
death
Primary Prevention
Secondary Prevention
Hypercholesterolemia

ASJC Scopus subject areas

  • Medicine(all)
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

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abstract = "The National Cholesterol Education Program (NCEP) guidelines published in 1993 made low-density lipoprotein cholesterol (LDL-C) the primary target of intervention. This decision was based on observations in familial hypercholesterolemia and on data from primary, secondary, and angiographic trials conducted prior to 1993. NCEP set the target goal for LDL-C as 100 mg/dL or less for secondary prevention and 130 mg/dL or less for primary prevention. Large-scale, well-designed, cholesterol-lowering trials conducted since 1993 substantiate these goal levels. In particular, the Scandinavian Simvastatin Survival Study and the Cholesterol and Recurrent Events trial showed that LDL-cholesterol-lowering with HMG-CoA reductase inhibitors (statins) reduced coronary events, coronary deaths, and total mortality in patients who had established coronary heart disease (CHD) with both elevated and normal cholesterol levels. These data, together with the NCEP guidelines, underscore the need for aggressive lipid-lowering therapy in patients at risk for CHD.",
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