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首页> 外文期刊>Journal of the American Pharmaceutical Association: APhA >New guidelines for managing hypercholesterolemia.
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New guidelines for managing hypercholesterolemia.

机译：管理高胆固醇血症的新指南。

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OBJECTIVE: To summarize for pharmacists the Adult Treatment Panel III (ATP III), recently issued guidelines for managing hypercholesterolemia, from the National Cholesterol Education Program (NCEP). DATA SOURCES: Executive summary of ATP III, and other pertinent literature as determined by the author. STUDY SELECTION: Not applicable. DATA EXTRACTION: By the author. DATA SYNTHESIS: Like previous guidelines issued by NCEP, ATP III focuses on lowering of low-density lipoprotein cholesterol (LDL-C) as a primary focus and using exercise, diet, and pharmacotherapy as a primary means of lowering patients' coronary heart disease (CHD) risks. The new guidelines recognize LDL-C levels of less than 100 mg/dL as optimal for all patients, and increase attention on high triglyceride levels (above 200 mg/dL). ATP III places more emphasis on identifying patients at risk for CHD and CHD events (e.g., myocardial infarctions, revascularization procedures). To apply the recommendations of ATP III in pharmaceutical care practice, pharmacists should follow a six-step process: (1) Assess the patient's lipid profile (full panel, not just total cholesterol); (2) assess and categorize the patient's CHD risk (using a point system reflecting the levels of risk inherent in certain factors); (3) establish treatment goals and approaches (the greater the risk, the more aggressive the management); (4) initiate therapeutic lifestyle changes (including new recommendations for low intake of saturated fats and dietary cholesterol); (5) initiate LDL-C lowering drug therapy (often with combination therapy); and (6) consider other lipid factors (particularly hypertriglyceridemia and the metabolic syndrome). CONCLUSION: Most patients who begin lipid-lowering therapy stop it within 1 year, and only about one-third of patients reach treatment goals. The release of the ATP III guidelines provides pharmacists a great opportunity to enhance pharmaceutical care services directed specifically at patients with hyperlipidemia.
机译：目的：为药剂师总结成人治疗小组III（ATP III），该小组最近发布了国家胆固醇教育计划（NCEP）的高胆固醇血症管理指南。数据来源：ATP III的执行摘要，以及作者确定的其他相关文献。研究选择：不适用。数据提取：作者。数据合成：像NCEP之前的指南一样，ATP III的重点是降低低密度脂蛋白胆固醇（LDL-C），而运动，饮食和药物治疗则是降低患者冠心病的主要手段（ CHD）风险。新指南认为，对于所有患者来说，低于100 mg / dL的LDL-C水平是最佳选择，并增加了对高甘油三酸酯水平（高于200 mg / dL）的关注。 ATP III更加着重于确定有CHD和CHD事件风险的患者（例如，心肌梗塞，血运重建程序）。为了将ATP III的建议应用到药物治疗实践中，药剂师应遵循六步过程：（1）评估患者的脂质状况（全图，而不仅仅是总胆固醇）; （2）评估和分类患者的冠心病风险（使用反映某些因素固有风险水平的积分系统）; （3）建立治疗目标和方法（风险越大，管理就越积极）; （4）启动治疗性生活方式的改变（包括针对低饱和脂肪和低胆固醇饮食的新建议）; （5）开始降低LDL-C的药物治疗（通常是联合治疗）; （6）考虑其他脂质因素（尤其是高甘油三酯血症和代谢综合征）。结论：大多数开始降脂治疗的患者在一年内就停止了降脂治疗，只有大约三分之一的患者达到了治疗目标。 ATP III指南的发布为药剂师提供了一个极大的机会来增强专门针对高脂血症患者的药物护理服务。

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