《2006VA/DoD美國(guó)血脂異常治療臨床實(shí)踐指南》內(nèi)容簡(jiǎn)介：

    In the VA/DoD guideline for Dyslipidemia （1999）， initial classification for primary prevention was based onmeasurement of TC and HDL-C. This guideline recommends measurement of LDL-C for screening purposes.This measurement requires a fasting lipid **ysis that includes total cholesterol, HDL-C, TG and estimation ofLDL-C. Classifications of these serum lipids are shown in Box 5. Persons with very high LDL-Cconcentrations can have one of several familial forms of hypercholesterolemia.

    《2006VA/DoD美國(guó)血脂異常治療臨床實(shí)踐指南》內(nèi)容預(yù)覽：

    Epidemiological studies have shown a direct relationship between elevated cholesterol and the incidence ofCVD （Law et al., 1994; Law, 1999）。 Elevated LDL-C is the most significant lipid abnormality for determiningtreatment goals, as many clinical trials have consistently shown that lowering LDL results in a reducedincidence of CVD. Recent studies with statins indicate that a 1 percent decrease in LDL-C reduces the risk forCVD by 1 percent （See Appendix F）。 LDL-C levels <100 mg/dl are associated with a very low-risk for CVD inthe population and therefore, are considered optimal. Patients without known CVD who have an LDL lowerthan 130 mg/dL have a relatively low incidence of cardiovascular events therefore levels of 100 – 129 mg/dl are considered near, but above optimal (Kannel, 1995). At borderline high LDL-C levels, 130-159 mg/dl,atherogenesis proceeds at a significant rate and accelerates as LDL-C increases, with a very high-risk at levels≥190 mg/dl. Low HDL-C is inversely associated with an increased risk for CVD. Although no threshold forlow HDL has been identified, an arbitrary value of <40 has been set as being low by the NCEP ATP-III (2002),and appears to be a reasonable set point. Elevated TG levels may be associated with increased risk for CVDand are commonly associated with other lipid and nonlipid risk factors. In persons with no CVD risk factorsTG levels are typically less than 100 mg/dl. Epidemiological studies suggest when TG levels are ≥ 200 mg/dl;the presence of increased quantities of atherogenic lipoproteins can heighten CVD risk beyond that predicted byLDL-C alone. However, there are no trials focusing on treatment of elevated triglycerides alone to loweradverse coronary events.

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