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February 5, 2014

2013 ACC/AHA Guideline on the Treatment of Blood CholesterolA Fresh Interpretation of Old Evidence

Author Affiliations
  • 1Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle
  • 2Group Health Research Institute, Group Health Cooperative, Seattle
  • 3Department of Epidemiology, University of Washington, Seattle
JAMA. 2014;311(5):461-462. doi:10.1001/jama.2013.284203

In 1984, the Lipid Research Clinics Program trial provided modest, if controversial, evidence that cholestyramine was associated with a reduction in the risk of coronary heart disease (CHD) in a primary prevention study of men.1 Other evidence for the emergence of a new treatable risk factor came from epidemiological studies, animal studies, and family studies.2 The National Heart, Lung, and Blood Institute (NHLBI) convened the National Cholesterol Education Program (NCEP) to develop recommendations about the detection, evaluation, and treatment of cholesterol in adults. The first Adult Treatment Panel (ATP) used levels of low-density lipoprotein (LDL) cholesterol to define both the thresholds for initiating treatment and the goals or targets of therapy.2

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