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December 1992

Barriers to Following National Cholesterol Educational Program Guidelines: An Appraisal of Poor Physician Compliance

Author Affiliations

Division of General and Preventive Medicine Department of Medicine University of Alabama at Birmingham Birmingham, AL 35294-3296

Arch Intern Med. 1992;152(12):2385-2387. doi:10.1001/archinte.1992.00400240011001

Coronary heart disease (CHD) remains the leading cause of death in the United States for both men and women, with an estimated prevalence of 6 million persons.1 Because death is the presenting event in approximately 15%2 of those developing CHD, and because of the prohibitively high expense of diagnosing and treating CHD, prevention is gaining attention. Dyslipidemia appears to be a necessary condition for the development of CHD. More important, lowering the cholesterol level decreases mortality from CHD by 2% for every 1% decrease in low-density lipoprotein (LDL) cholesterol.3 Multiple clinical trials also indicate that lowering the cholesterol level can arrest the progression of established atherosclerosis and even lead to regression of lesions.4 More than half of patients with premature CHD have a familial lipoprotein disorder.5 One third of middle-aged Americans have serum total cholesterol values equal to or greater than 6.21 mmol/L (≥240 mg/dL)

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