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Because the link between CAD and cholesterol has been clinically demonstrated and widely accepted, many approaches to addressing cholesterol have been explored. While efforts aimed at public education that target diet and exercise have made a positive impact on CAD, lifestyle pressures appear to cause a large number of patients to fail to reach target cholesterol levels with diet and exercise programs . Additionally, 20% of the population have two or more risk factors for CAD and, therefore, require more aggressive cholesterol lowering.
Analysis of epidemiological and clinical data has led to recommendations for the treatment and management of elevated lipid levels. While the 1988 Canadian Consensus Guidelines established moderate and high risk total cholesterol and LDL-C levels, the NCEP guidelines have established definitive treatment goals for LDL-C levels (Table 8). An interim report from the Canadian Working Group on Hypercholesterolemia and Other Dyslipidemias, reviewing the latest evidence for the recommendation of the detection and management of hypercholesterolemia in Canada, has recently been published. buy ortho tri-cyclen online
TABLE 8 United States National Cholesterol Education Program guidelines for lipid management
|Definite||Two or more|
|Yes||Yes or No||>3.4||<2.6|
*Definite atherosclerotic disease is defined as coronary artery disease (CAD) or peripheral vascular disease (including symptomatic carotid artery disease); f Other risk factors for CAD are age (males older than 45 years of age, females older than 55 years of age or premature menopause without estrogen replacement therapy), family history of premature CAD, current cigarette smoking, hypertension, confirmed high density lipoprotein cholesterol (HDL-C) less than 0.9 mmol/L and diabetes mellitus. Subtract one risk factor if HDL-C is greater than 1.6 mmol/L. LDL-C Low density lipoprotein cholesterol.