Cholesterol screening and management guidelines

BMJ 1999;318:1140 ( 24 April )

Letters

Cholesterol screening and management guidelines

Having several guidelines is confusing

Policy based on Sheffield table fully satisfies authors' criteria

Having several guidelines is confusing

The first 150 words of the full text of this article appear below.

EDITOR $---$ Unwin et al highlight the fact that several widely available guidelines for the management of hyperlipidaemia giveconflicting advice for the primary prevention of cardiovasculardisease.¹ Some of the issues deserve furtherscrutiny.

The New Zealand guidelines are based entirely on the ratio of total to high density lipoprotein cholesterol concentrationsfor calculation of the absolute risk of cardiovascular diseaseover five years.² The American national cholesterol educationprogram, however, clearly says that it does not recommend useof the ratio of either total or low density lipoprotein cholesterolto high density lipoprotein cholesterol³; instead it recommendsuse of the absolute high and low density lipoprotein cholesterolconcentrations. The rationale behind this is that these concentrationsare independent risk factors with different determinants; combiningthem into a single number conceals information about either orboth, which might be important for making clinical decisions.A patient with raised . . . [Full text of this article]

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Implications of applying widely accepted cholesterol screening and management guidelines to a British adult population: cross sectional study of cardiovascular disease and risk factors: Nigel Unwin, Richard Thomson, Ann Marie O'Byrne, Mike Laker, and Heather Armstrong
BMJ 1998 317: 1125-1130. [Abstract] [Full Text] [PDF]