Sabharwal Anup K, Boord Jeffrey B
VA Tennessee Valley Geriatrics Research, Education, and Clinical Center, 1310 24th Avenue South, Nashville, TN 37212, USA.
Curr Atheroscler Rep. 2006 Jan;8(1):19-25. doi: 10.1007/s11883-006-0060-6.
Outcomes from recent lipid-lowering trials have led to an update of the third Report of the National Cholesterol Education Program (NCEP) Adult Treatment Panel's guidelines for treatment of hypercholesterolemia in adults. The updated NCEP guidelines now offer an optional goal of low-density lipoprotein (LDL) cholesterol of less than 70 mg/dL for high-risk individuals. Epidemiologic and clinical trial data suggest that for every 30-mg/dL change in LDL, the relative risk for coronary heart disease changes by about 30%. Statin therapy effectively lowers LDL and has an overall excellent safety profile in clinical trials. However, the use of high-dose statin therapy also entails greater risk of adverse events, such as myopathy and liver function test abnormalities, and this must be carefully weighed against the potential benefit for each patient. Alternative approaches targeting high-density lipoproteins and triglycerides may offer yet another option for coronary heart disease prevention in high-risk patients.
近期降脂试验的结果促使美国国家胆固醇教育计划（NCEP）成人治疗小组第三次报告中关于成人高胆固醇血症治疗指南得到更新。更新后的NCEP指南现在为高危个体提供了一个低密度脂蛋白（LDL）胆固醇低于70mg/dL的可选目标。流行病学和临床试验数据表明，LDL每变化30mg/dL，冠心病的相对风险约变化30%。他汀类药物疗法可有效降低LDL，并且在临床试验中总体安全性良好。然而，使用高剂量他汀类药物疗法也会带来更高的不良事件风险，如肌病和肝功能检查异常，必须针对每位患者仔细权衡其潜在益处。针对高密度脂蛋白和甘油三酯的替代方法可能为高危患者预防冠心病提供另一种选择。
