RATIONALE FOR AND OUTLINE OF THE RECOMMENDATIONS OF THE WORKING GROUPON HYPERCHOLESTEROLEMIA AND OTHER DYSLIPIDEMIAS - INTERIM-REPORT

A panel consisting of lipidologists, epidemiologists, cardiologists, i nternists, general practitioners, and public health and government rep resentatives used the evidence-based approach to examine the rationale for a draft of recommendations for medical management of lipid disord ers. The proposed recommendations deal with assessment of cardiovascul ar risk based on history, physical examination and laboratory findings ; assessment of the fasting lipid profile; diagnosis and treatment of secondary risk factors; calculation of the 10-year risk of a cardiac e vent; initiation of lifestyle modifications in patients in whom low de nsity lipoprotein cholesterol (LDL-C), total:high density lipoprotein cholesterol (HDL-C) ratio or triglycerides exceeds target values based on a patient's risk category; follow-up; treatment with drugs; and ch oices of drugs. In contrast to previous recommendations, there are new , considerably lower, cholesterol level targets for secondary preventi on, with a less important emphasis on total cholesterol value than on LDL-C or total:HDL-C ratio and triglyceride levels, and an emphasis on determining the likelihood of a cardiac event by evaluating all relev ant risk factors and sharpening the focus on nondrug treatment, which should result in treating a greater percentage of at-risk patients.