madhav vissa. atp iii adult treatment panel guidelines for tx of high cholesterol based on...
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RATIONALE FOR TREATMENT GUIDELINESMadhav Vissa
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ATP III
Adult Treatment Panel Guidelines for tx of High Cholesterol Based on epidemiological
evidence about
risk factors for CHD
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↑ Cholesterol ↑ CHD Risk
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5 steps to determine risk
Step 1 – Lipid Profile Step 2 – CHD Equivalents
CHD is a risk factor for coronary events, other things are too.○ DM○ Symptomatic CAD○ Peripheral artery dz○ AAA○ Chronic Kidney Dz
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More Steps
Step 3 – Other major Risk factors (not LDL)Smoking, HTN, Low HDL (<40), Fam Hx, Older
age Stage 4 – ≥2 risk factors +/- CHD Equivalent
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• Based on Framingham risk tables – may overestimate risk in European and Asian Populations
• Do not need to do this in pt with 1 or fewer risk factors (10 year risk of CHD is <10%)
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Step 5
“determine the risk category that establishes the LDL goal”More risk factors = lower LDL moreInitiate drug therapy if LDL cannot be
lowered to desired level with lifestyle changes
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References
UpToDate - ATP III guidelines for treatment of high blood cholesterol