Madhav Vissa. ATP III Adult Treatment Panel Guidelines for tx of High Cholesterol Based on...
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Transcript of Madhav Vissa. ATP III Adult Treatment Panel Guidelines for tx of High Cholesterol Based on...
RATIONALE FOR TREATMENT GUIDELINESMadhav Vissa
ATP III
Adult Treatment Panel Guidelines for tx of High Cholesterol Based on epidemiological
evidence about
risk factors for CHD
↑ Cholesterol ↑ CHD Risk
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
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
• 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%)
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
References
UpToDate - ATP III guidelines for treatment of high blood cholesterol