Fletcher D J, Rogers D A
Postgrad Med. 1985 Apr;77(5):319-28. doi: 10.1080/00325481.1985.11698970.
Although coronary heart disease (CHD) remains the No. 1 cause of death in the United States, the CHD mortality rate has shown a recent decline. This has been attributed to lower fat consumption in the general population, with associated lower serum cholesterol levels. Thus, diet seems to be an important factor in controlling cholesterol level. Acting on this hypothesis, primary care physicians can help patients make appropriate dietary changes. We believe that persons at risk of hypercholesterolemia need to be identified in adolescence by measurement of total serum cholesterol level and that testing should be done every two years after age 25. The American Heart Association's prudent diet is recommended for all patients, especially those with a serum cholesterol level above 240 mg/dl. When dietary restriction does not bring the level within this limit, use of cholesterol-lowering agents is considered. To be lasting, dietary change must be gradual; realistic immediate and long-term goals should be established. In addition, the diet must be nutritionally sound and the patient must receive support from family members.
尽管冠心病（CHD）仍是美国头号死因，但冠心病死亡率最近呈下降趋势。这归因于普通人群脂肪摄入量降低，以及随之降低的血清胆固醇水平。因此，饮食似乎是控制胆固醇水平的一个重要因素。基于这一假设，初级保健医生可以帮助患者做出适当的饮食改变。我们认为，需要在青少年时期通过测量血清总胆固醇水平来确定有高胆固醇血症风险的人群，并且25岁以后应每两年进行一次检测。建议所有患者采用美国心脏协会的谨慎饮食，尤其是那些血清胆固醇水平高于240毫克/分升的患者。当饮食限制不能使胆固醇水平降至这一限度内时，考虑使用降胆固醇药物。要想持久，饮食改变必须循序渐进；应制定切实可行的近期和长期目标。此外，饮食必须营养合理，患者必须得到家庭成员的支持。
