Guidelines for the Detection and Treatment of Elevated Serum Cholesterol: Which Is the Baby and Which Is the Bathwater?

Excerpt

Few contemporary issues have drawn as much attention as the guidelines from the National Cholesterol Education Program (NCEP) Expert Panel on the Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (1). The clinician, meanwhile, finds himor herself trapped between two apparently opposing forces. One force is the formidable array of evidence proving the etiologic role of cholesterol in atherosclerotic coronary artery disease. This evidence has been greatly bolstered by the ever-increasing number of clinical trials, mostly in middle-aged white men, showing that cholesterol-lowering by diet or drugs can prevent not only the onset of coronary artery disease (2-4)