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Statins & the ATP III Guidelines

The Adult Treatment Panel III (ATP III) guidelines from the National Cholesterol Education Program forth procedures for managing cholesterol. Therapeutic lifestyle changes and statin drug therapy are aimed at reducing low-density lipoprotein (LDL) or bad cholesterol and increasing high-density lipoprotein (HDL) or good cholesterol. The ATP III guidelines direct medical professionals on when to initiate the use of lifestyle changes and statins should be initiated. By following the medical guidelines, doctors can ensure good outcomes for their patients.

  1. What Are NCEP and ATP?

    • Created in 1985, the National Cholesterol Education Program is an initiative under the National Heart, Lung and Blood Institute. Its purpose is to lower incidences of coronary heart disease, a main cause of death in the U.S., by educating the public and health professionals about the importance of lowering bad cholesterol levels. For instance, the NCEP established the desirable, borderline and undesirable level ranges that are used when measuring HDL, LDL and triglycerides.

      The Adult Treatment Panel is a component of the National Cholesterol Education Program. It is an expert panel of health professionals who are tasked with setting protocols for prescribing statins. Statins are drugs that lower LDL cholesterol by prohibiting a chemical in the liver from making cholesterol.

    Purpose of ATP III Guidelines

    • The ATP III guidelines update previously released rules after the completion of clinical trials on statins showed even further evidence on the importance of lowering cholesterol levels as early as possible.

      Through the guidelines, the Adult Treatment Panel translates results of the statins research into practical steps that medical professionals and the general public can follow to lower the risk of cardiovascular disease and coronary heart disease.

    Modified Protocols Under ATP III

    • Among other modifications, the ATP III guidelines expand the definition of high-risk individuals. For instance, a higher number of older people and individuals with diabetes fall under ATP III guidelines as benefiting from cholesterol lowering therapy. This modification greatly increases the number of individuals who should be prescribed statins.

      The ATP III guidelines also recommend drug therapy for individuals who may have multiple risk factors for cardiovascular disease or coronary heart disease but have low LDL cholesterol levels. Risk factors include family history of coronary heart disease, hypertension, cigarette smoker and age (45 and older for men and 55 and older for women).

    TLC Versus Statins

    • The ATP III guidelines specifically pinpoint the instances when therapeutic lifestyle changes, such as diet and exercise, should be prescribed versus when drug therapy, such as the use of statins, should be considered.

      For individuals with a high risk of cardiovascular disease or coronary heart disease, drug therapy is recommended for LDL levels over 70mg. For people with a moderately high risk, the ATP guidelines suggest initiating lifestyle changes when LDL is 130mg or higher. Statins drug therapy can now be considered when bad cholesterol levels are between 100 and 129mg.

      For people with moderate risk, TLC is recommended when LDL is 130mg or higher, while drug therapy is needed at 160mg or higher. With lower risk individuals, TLC is initiated when bad cholesterol is 160mg and higher and statins therapy when LDL is 190mg or higher. However, statins can now be considered when LDL levels are between 160 and 189mg.

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