What's Up With the New Cholesterol Guidelines?

What's up with the new cholesterol guidelines? If you have high cholesterol, you probably have questions about the new recommendations. For example, what happened to LDL goals? And why is there now so much focus on heart-healthy eating and other lifestyle changes? The cholesterol guidelines have been updated to reflect the latest research on stroke and heart attack risk. Read on to learn more.

 

What Are Cholesterol Guidelines?

Cholesterol guidelines are a set of recommendations for doctors or other healthcare providers who are treating people with high cholesterol. The guidelines are created by a panel of cholesterol experts appointed by the American College of Cardiology (ACC) and the American Heart Association (AHA). This panel, known as the Adult Treatment Panel, or ATP, includes professionals such as primary care physicians, cardiologists, endocrinologists, and other experts in the field.
 
The panel begins by looking at the detection, evaluation, and treatment of high cholesterol in adults. The ATP evaluates clinical studies and the patterns, causes, and effects of heart disease in order to develop the guidelines. The recommendations the ATP creates are then outlined in a report and published. These guidelines are periodically revised, with the most current being the ATP IV guidelines, which came out in November 2013.
 

The Old Guidelines

The first set of guidelines (ATP I) was published in 1988, followed by the ATP II guidelines in 1993, and the ATP III guidelines in 2002. As new information arises through clinical studies and practice experience, guidelines are updated or revised completely. Information from previous guidelines may be proven ineffective or unnecessary, and this prompts changes in current guidelines.
 
The ATP III guidelines were last updated in 2004. This set of guidelines looked at a person's low-density lipoprotein (LDL) cholesterol, total cholesterol (TC), and high-density lipoprotein (HDL) cholesterol and classified each of those categories as either being in a desirable range or being too low/high. The LDL was the primary treatment focus. This meant that the starting point for treatment was choosing a medication that would reduce a person's LDL into a desirable range.
 
The next step looked at conditions that put you at higher risk for heart disease and then looked at major risk factors other than LDL. These risk factors included:
 
 
The next step evaluated your 10-year heart disease risk by looking at age, total cholesterol, smoking, HDL cholesterol, and systolic blood pressure (the top number in a blood pressure reading).
 
Different medications were used to target different aspects of cholesterol, and multidrug therapy was often used to reach goals; again, the focus was on reaching LDL goals. The specific LDL goals for each individual were determined by their risk factors and their 10-year risk of heart disease.
 
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