Cholesterol management: guidelines have changed, although diet is still central.

1. The second report of the National Cholesterol Education Program's Adult Treatment Panel re-emphasizes low density lipoprotein cholesterol as the main target of cholesterol lowering therapy; dietary therapy as the first line approach to cholesterol management; and the reservation of drug therapy for clients at high risk for coronary heart disease (CHD). 2. In the new treatment guidelines, the type and intensity of cholesterol treatment, which now involves a greater emphasis on the high density lipoprotein cholesterol level, is guided by the client's CHD risk status. 3. Under the new recommendations, dietary management of high blood cholesterol, which is the cornerstone of cholesterol intervention, should also include greater attention to increasing the client's physical activity and losing weight if needed. 4. The new cholesterol intervention guidelines not only provide occupational health nurses with new directions for cholesterol intervention, but reinforce the critical role of nurses in providing a more holistic, integrated approach to risk factor reduction.