Circulacion

Managing Abnormal Blood Lipids: A Collaborative Approach Barbara Fletcher, Kathy Berra, Phil Ades, Lynne T. Braun, Lora E. Burke, J. Larry Durstine, Joan M. Fair, Gerald F. Fletcher, David Goff, Laura L. Hayman, William R. Hiatt, Nancy Houston Miller, Ronald Krauss, Penny Kris-Etherton, Neil Stone, Janet Wilterdink and Mary Winston Circulation 2005;112;3184-3209 DOI:10.1161/CIRCULATIONAHA.105.169180
Circulation is published by the American Heart Association. 7272 Greenville Avenue, Dallas, TX 72514 Copyright © 2005 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online ISSN: 1524-4539

The online version of this article, along with updated information and services, is located on the World Wide Web at: http://circ.ahajournals.org/cgi/content/full/112/20/3184Subscriptions: Information about subscribing to Circulation is online at http://circ.ahajournals.org/subscriptions/ Permissions: Permissions & Rights Desk, Lippincott Williams & Wilkins, a division of Wolters Kluwer Health, 351 West Camden Street, Baltimore, MD 21202-2436. Phone: 410-528-4050. Fax: 410-528-8550. E-mail: journalpermissions@lww.com Reprints: Information about reprints can befound online at http://www.lww.com/reprints

Downloaded from circ.ahajournals.org by on June 28, 2011

AHA Scientific Statement
Managing Abnormal Blood Lipids
A Collaborative Approach Cosponsored by the Councils on Cardiovascular Nursing; Arteriosclerosis, Thrombosis, and Vascular Biology; Basic Cardiovascular Sciences; Cardiovascular Disease in the Young; Clinical Cardiology; Epidemiology andPrevention; Nutrition, Physical Activity, and Metabolism; and Stroke; and the Preventive Cardiovascular Nurses Association
Barbara Fletcher, MSN, FAAN, FAHA, Writing Group Co-Chair; Kathy Berra, MSN, ANP, FAAN, FAHA, Writing Group Co-Chair; Phil Ades, MD; Lynne T. Braun, PhD, RN, CS; Lora E. Burke, PhD, RN; J. Larry Durstine, PhD, FACSM, FAACVPR; Joan M. Fair, RN, ANP, PhD; Gerald F. Fletcher,MD, FAHA; David Goff, MD; Laura L. Hayman, PhD, RN; William R. Hiatt, MD; Nancy Houston Miller, RN, BSN, FAACVPR; Ronald Krauss, MD; Penny Kris-Etherton, PhD, RD; Neil Stone, MD; Janet Wilterdink, MD; Mary Winston, EdD, RD
Abstract—Current data and guidelines recommend treating abnormal blood lipids (ABL) to goal. This is a complex process and requires involvement from various healthcareprofessionals with a wide range of expertise. The model of a multidisciplinary case management approach for patients with ABL is well documented and described. This collaborative approach encompasses primary and secondary prevention across the lifespan, incorporates nutritional and exercise management as a significant component, defines the importance and indications for pharmacological therapy, andemphasizes the importance of adherence. Use of this collaborative approach for the treatment of ABL ultimately will improve cardiovascular and cerebrovascular morbidity and mortality. (Circulation. 2005;112:31843209.) Key Words: AHA Scientific Statements lipids risk factors cholesterol prevention

levated low-density lipoprotein cholesterol (LDL-C) is a major cause of coronary heart disease (CHD).The relationship between LDL-C and CHD risk is continuous over a broad range of LDL-C levels: The higher the LDL-C level, the greater the CHD risk.1 Although national guidelines for cholesterol management have existed since 1988,2 many individuals who are treated for elevated cholesterol have not achieved their targeted cholesterol levels. Studies3,4 show that 17% to 73% of treated patientsactually meet their target levels, but the people at greatest risk (patients with known CHD) rarely achieve their target levels (Figure). The Third Report of the National Choles-

E

terol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults,5 known as Adult Treatment Panel III (ATP III), called for more aggressive treatment of...