Evaluation and management of lipid disorders

Plasma lipids play a key role in the development of atherosclerosis. Recent trial data support early identification of asymptomatic adults with high-r isk lipid profiles for primary prevention of coronary heart disease. 3-Hydr oq-3-methylglutaryl coenzyme A reductase inhibitors have been shown to redu ce coronary events in both asymptomatic adults and those with known coronar y heart disease. The optimal plasma low-density lipoprotein cholesterol for secondary coronary prevention remains controversial. The Second Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Chole sterol in Adults (Adult Treatment Panel II), published in 1993 by the Natio nal Cholesterol Education Program, recommends guidelines for evaluation and diagnosis of lipids. Subsequently, several clinical trials have identified populations benefiting from pharmacologic intervention and new approaches to the management of lipid disorders. Consequently, these guidelines should be applied with the interval evidence in mind. Curr Opin Cardiol 1999, 14: 298-302 (C) 1999 Lippiocott Williams & Wilkins, Inc.