Madhav Vissa
ATP III Adult Treatment Panel Guidelines for tx of High Cholesterol Based on epidemiological evidence about risk factors for CHD
↑ Cholesterol ↑ CHD Risk
5 steps to determine risk Step 1 – Lipid Profile Step 2 – CHD Equivalents CHD is a risk factor for coronary events, other things are too. ○ DM ○ Symptomatic CAD ○ Peripheral artery dz ○ AAA ○ Chronic Kidney Dz
More Steps Step 3 – Other major Risk factors (not LDL) Smoking, HTN, Low HDL (<40), Fam Hx, Older age Stage 4 – ≥ 2 risk factors +/- CHD Equivalent
Based on Framingham risk tables – may overestimate risk in European and Asian Populations Do not need to do this in pt with 1 or fewer risk factors (10 year risk of CHD is <10%)
Step 5 “determine the risk category that establishes the LDL goal” More risk factors = lower LDL more Initiate drug therapy if LDL cannot be lowered to desired level with lifestyle changes
References UpToDate - ATP III guidelines for treatment of high blood cholesterol