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