Abstract
Figures and Tables
Table 2
*Trans fatty acids are another LDL-raising fat that should be kept at a low intake. †Carbohydrate should be derived predominantly from foods rich in complex carbohydrates induding grains, especially whole grains, fruits, and vegetables. ‡Daily energy expenditure should include at least moderate physical activity (contributing approximately 200 Kcal per day).
Table 3
*CHD includes history of myocardial infarction, unstable angina, stable angina, coronary artery procedures (angioplasty or bypass surgery), or evidence of clinically significant myocardial ischemia. †CHD risk equivalents include clinical manifestations of noncoronary forms of atherosclerotic disease (peripheral arterial disease, abdominal aortic aneurysm, and carotid artery disease [transient ischemic attacks or stroke of carotid origin or > 50% obstruction of a carotid artery]), diabetes, and 2+ risk factors with 10-year risk for hard CHD > 20%. ‡Risk factors include cigarette smoking, hypertension (BP ≥ 140/90 mm Hg or on antihypertensive medication), low HDL cholesterol (< 40 mg/dL), family history of premature CHD (CHD in male first-degree relative < 55 years of age; CHD in female first-degree relative < 65 years of age), and age (men ≥ 45 years; women ≥ 55 years). §§Electronic 10-year risk calculators are available at www.nhlbi.nih.gov/guidelines/cholesterol. §Almost all people with zero or 1 risk factor have a 10-year risk < 10%, and 10-year risk assessment in people with zero or 1 risk factor is thus not necessary. ∥Very high risk favors the optional LDL-C goal of < 70 mg/dL, and in patients with high triglycerides, non-HDL-C < 100 mg/dL. ¶Optional LDL-C goal < 100 mg/dL. #Any person at high risk or moderately high risk who has lifestyle-related risk factors (eg, obesity, physical inactivity, elevated triglyceride, low HDL-C, or metabolic syndrome) is a candidate for therapeutic lifestyle changes to modify these risk factors regardless of LDL-C level. **When LDL-lowering drug therapy is employed, it is advised that intensity of therapy be sufficient to achieve at least a 30% to 40% reduction in LDL-C levels. ††If baseline LDL-C is < 100 mg/dL, institution of an LDL-lowering drug is a therapeutic option on the basis of available clinical trial results. If a high-risk person has high triglycerides or low HDL-C, combining a fibrate or nicotinic acid with an LDL-lowering drug can be considered. ‡‡For moderately high-risk persons, with LDL-C level is 100 to 129 mg/dL, at baseline or on lifestyle therapy, initiation of an LDL-lowering drug to achieve an LDL-C level < 100 mg/dL is a therapeutic option on the basis of available clinical trial results.