Volume 103, Issue s73

This review of lipid-lowering trials looks at both the primary and secondary prevention of coronary heart disease. It also introduces evidence pointing toward the emerging importance of nonlipid risk factors in the pathogenesis of atherosclerosis. This review is designed to enhance the primary care physician's working knowledge of the evidence supporting the importance of LDL-C reduction and the central role of statin therapy in the reduction of the risk of coronary heart disease, as well as provide a greater understanding of emerging risk factors.

The Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) provides an evidence-based approach to the diagnosis of dyslipidemia and the management of low-density lipoprotein cholesterol (LDL-C). This article provides a brief overview of the ATP III therapeutic approach (therapeutic lifestyle changes alone or in combination with a pharmacologic agent) in which the patient's level of risk for coronary heart disease guides the intensity of intervention to lower LDL-C concentrations. Because statins have been found to effectively help patients reach ATP III target LDL-C levels to reduce their risk of coronary events, they tend to be the treatment of choice when initial therapy with therapeutic lifestyle changes alone fails to achieve the target level. Discussion includes a summary of the beneficial properties of statins beyond lipid lowering.