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LipidManagement™ is certified
for CME credit. Save your quarterly issues this year, as they
will be needed for the CME posttest in December 2001.
LEARNING OBJECTIVES
After reading the articles in this issue of LipidManagement™,
participants should be able to:
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Discuss the new cholesterol goals of
the Adult Treatment Panel III guidelines and the reasoning
behind changes in those goals |
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Recognize the multiple risk factors that
influence a person's chance of developing coronary heart
disease |
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Explain the differences and
similarities between the ATP III and the ATP II guidelines
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Intended audience:
primary care physicians, cardiologists, endocrinologists
Release date: September 24, 2001
End date: September 30, 2002
This newsletter series is sponsored by Professional Postgraduate
Services® (PPS), a division
of Physicians World/Thomson Healthcare.
PPS is accredited by the Accreditation Council
for Continuing Medical Education to provide continuing medical
education for physicians.
PPS designates this educational activity for a maximum
of 2 hours in category 1 credit toward the AMA Physician’s Recognition
Award. Each physician should claim only those hours of credit
that he/she actually spent in the educational activity.
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From
the ATP III Chairman
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Scott
M. Grundy,
MD, PhD |
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Scott Grundy, MD, PhD, Director of the Center
for Human Nutrition at the University of Texas Southwestern Medical
Center in Dallas, served as Chairman of the Third Report of the
Adult Treatment Panel from the National Cholesterol Education Program
(NCEP's ATP III). Dr Grundy, a member of the Steering Committee
of the NLEC, offers his perspective on the new cholesterol guidelines.
If I were to single out one area of emphasis
in ATP III, it would be on short-term, high-risk primary prevention—while
still supporting long-term, secondary prevention. In ATP I (1988),
the main emphasis was on long-term primary prevention—treating
people with high cholesterol to prevent atherosclerosis in the long
term. In ATP II (1993), because of emerging evidence and demonstrated
benefit, some of the emphasis shifted to secondary prevention.
Short-term prevention (<10 years) refers
to prevention of plaque rupture and acute coronary syndromes. Long-term
prevention (>10 years), conversely, is aimed towards preventing
development of atherosclerosis. Physicians must recognize the two
reasons for lowering cholesterol: to prevent acute coronary syndromes
by stabilizing plaques, and to prevent atherosclerosis development
in the long term.
ATP III is a continuation of previous reports.
In ATP I, we identified dietary therapy as first-line treatment.
LDL-lowering drugs were reserved only for high or very high LDL-C
levels, with the idea of preventing atherosclerosis in the long
term. We kept that emphasis in ATP II but, based on new evidence,
also added the focus of secondary prevention in patients with established
coronary disease. By taking a further step, ATP III allows the opportunity
for more intensive lipid-lowering treatment in a larger population
of patients, with special emphasis on those with multiple risk factors.
Also, bringing in Framingham risk scoring allows us to become quantitative
in defining the 10-year CHD risk categories.
The final ATP III document is an evidence-based
report that includes close to 1,000 references and represents a
synthesis of all the data from major clinical trials. The major
aim of the guidelines is to maximize benefit at acceptable cost-effectiveness.
With these guidelines, our goal is to facilitate the physician's
clinical judgment, not replace it. We believe ATP III accomplishes
that. 
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