Management of hyperlipidemia: new LDL-C targets for persons at high-risk forcardiovascular events.

摘要

Coronary heart disease (CHD) remains the leading cause of mortality inthe United States, and is associated with significant health care costs. Current evidence overwhelminglyconfirms the role of low-density lipoprotein cholesterol (LDL-C) in the pathogenesis of atherosclerosisand the risk of CHD events. The approach to the management of hyperlipidemia has evolved dramaticallyover the past decade. Randomized clinical trails have provided strong evidence that lowering plasma cholesterolwith statins reduces the risk of cardiovascular events, particularly in high-risk patients, irrespectiveof baseline cholesterol levels. The National Cholesterol Education Program (NCEP) report was releasedin July 2004. The report examined the results of recently concluded clinical trials and provided consensusrecommendations on the management of hyperlipidemia. The report expands on the core content of the previouslypublished guidelines. However, it is by far the most aggressive approach to date for reducing CHD risk.A focal element of the report is the modification of LDL-C goal in high-risk patients to