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(Circulation. 1996;93:1067-1068.)
© 1996 American Heart Association, Inc.

Articles

Cholesterol Screening in Asymptomatic Adults

No Cause to Change

Task Force on Risk Reduction, American Heart Association¹

	Introduction

 
The American College of Physicians (ACP), in the March 1 issue of Annals of Internal Medicine,¹ proposes new guidelines for cholesterol testing for the prevention of coronary heart disease in adults. These guidelines differ substantially from those initially proposed² and later revised³ by the National Cholesterol Education Program (NCEP) Adult Treatment Panel, endorsed by the American Heart Association (AHA), and from the previous American College of Physicians guidelines. It should be noted that the NCEP/AHA guidelines were reviewed and endorsed by representatives of more than 40 organizations, including the American College of Physicians. The Task Force on Risk Reduction of the AHA is concerned about the detrimental effects to the general public, to high-risk patients, and to their physicians that may emanate from this proposed modification in American College of Physicians guidelines for cholesterol testing. A review of the flaws in advocating change in the NCEP/AHA guidelines as currently widely accepted and implemented is presented here.

The proposed ACP guidelines¹ and the accompanying background article by Garber et al⁴ recommend screening for lipid abnormalities only in men aged 35 to 65 years and women aged 45 to 65 years and using only a total cholesterol level. Even in these people, it is considered appropriate but not mandatory. Cholesterol measurement might be considered 5 to 10 years earlier if there is evidence of a familial lipoprotein disorder or two other characteristics that place the individual at increased risk of coronary heart disease. These guidelines would thus exclude many persons 65 years . . . [Full Text of this Article]

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				A. M. Garber and W. S. Browner Cholesterol Screening Guidelines : Consensus, Evidence, and Common Sense Circulation, March 18, 1997; 95(6): 1642 - 1645. [Full Text]

				New Screening Guidelines Fuel Cholesterol Debate Journal Watch Cardiology, April 1, 1996; 1996(401): 6 - 6. [Full Text]