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What's New? Guidelines and Goals

Clinical Pharmacy Practice, University of Cincinnati College of Pharmacy, Cincinnati, Ohio

Kim K. Birtcher, MS, PharmD, BCPS, CDE

University of Houston College of Pharmacy, 1441 Moursund Street, Houston, TX 77030

Several expert panels have written guidelines regarding the treatment of dyslipidemias. The recommendations from the National Cholesterol Education Program (NCEP); American Diabetes Association (ADA); American Heart Association (AHA); National Heart, Blood, and Lung Institute (NHBLI); and National Kidney Foundation (NKF) will be reviewed. The guidelines agree on several points: using the fasting lipid panel as the initial screening tool, targeting low-density lipoprotein cholesterol (LDL-C) initially, and achieving lower LDL-C goals. Some guidelines are more aggressive than those of the NCEP: the ADA and AHA have defined low high-density lipoprotein cholesterol as <50 mg/dL for women; the ADA recommends a need for drug therapy when the patient's total cholesterol, rather than LDL-C, is 135 mg/dL for patients who are older than 40 years; the NKF and the AHA have classified patients with chronic kidney disease in the high-risk category; and the AHA has revised the diagnostic criteria for metabolic syndrome to include additional people. More patients are qualifying for lifestyle modifications and medication treatment. A subset of these patients may require combination cholesterol-lowering medications to reach the new goals. Pharmacists will need to keep current with the literature and be knowledgeable about the guidelines to maximize the care given to our patients.

Key Words: Guidelines • cholesterol • dyslipidemias • goals • metabolic syndrome

Journal of Pharmacy Practice, Vol. 19, No. 2, 103-112 (2006)
DOI: 10.1177/0897190006290329


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