A national program for lowering high blood cholesterol

Abstract

The National Institutes of Health have begun a new National Cholesterol Education Program. This program is modeled on the 15-year-old National High Blood Pressure Education Program, which has played a major role in improving the detection and treatment of hypertension in this country. Similar success can be predicted for the National Cholesterol Education Program, given the similarity between these two risk factors--hypertension and cholesterol--in (1) the accumulated scientific evidence for the benefit of intervention, (2) the availability of classification and treatment guidelines, and (3) the approach to professional and public health education programs. The new National Cholesterol Education Program guidelines recommend that all adults undergo a blood cholesterol measurement at least once every 5 years. Patients with a level greater than 200 mg/dl (confirmed by a second measurement) should be advised to adopt a step 1 fat-controlled diet. Patients with a cholesterol level greater than 240 mg/dl are candidates for intensive treatment with step 2 diet and sometimes drugs, as are those in the 200 to 240 mg/dl range who are at especially high risk because they already have coronary heart disease or two other risk factors. However, drugs for lowering blood cholesterol levels should be used only when the indication has been confirmed by measurements of low-density lipoprotein cholesterol and as a supplement to continuing the dietary treatment.