Therapy and prevention of coronary heart diseases through lowering of the serum cholesterol levels; third consensus 'Cholesterol'. Consensus Working Group, CBO

For the second time the consensus text for lipid lowering therapy is revised. In angiographic studies it was shown that a decrease in the total cholesterol as well as the low-density lipoprotein cholesterol level results in a reduction of the progression of vascular disease. Furthermore, intervention trials demonstrated that therapy with cholesterol synthesis inhibitors reduces not only both the cardiovascular and total mortality, but also other manifestations of coronary heart disease (CHD). Hypercholesterolaemia is treated with a low-fat diet and normalisation of the weight. For individuals, this might result in a reduction of the risk for myocardial infarction or death and for the population in a decrease of the mean serum cholesterol concentration and the incidence of CHD. The indication for drug therapy is founded on the expected effectiveness to reduce the incidence of (new manifestations of) CHD, which is related to the level of the absolute risk of vascular disease. In persons without known vascular diseases this risk is calculated from the total and high-density lipoprotein cholesterol ratio, age, sex, blood pressure, diabetes mellitus, and smoking. Treatment with cholesterol synthesis inhibitors must be considered in (a) patients with familial hypercholesterolaemia, (b) all patients with a history of myocardial infarction or other symptomatic vascular disease with a total cholesterol concentration above 5.0 mmol/l and a life expectancy of at least five years; (c) persons with a combination of diabetes mellitus, hypertension, hypercholesterolaemia and high risk for development of CHD, rising from 25% per 10 years at the age of 40 years to 35-40% per 10 years at the age of 70 years, with a life expectancy of at least five years. If these guidelines are followed, the upper limit of the calculated cost-effectiveness is about Dfl. 40,000 per life year gained. The working group judges this reasonable in comparison with other therapeutic interventions in the Netherlands.

Errataetall:

ErratumIn: Ned Tijdschr Geneeskd 1998 Oct 3;142(40):2232

Medienart:

Artikel

Erscheinungsjahr:

1998

Erschienen:

1998

Enthalten in:

Zur Gesamtaufnahme - volume:142

Enthalten in:

Nederlands tijdschrift voor geneeskunde - 142(1998), 38 vom: 19. Sept., Seite 2096-101

Sprache:

Niederländisch

Weiterer Titel:

Behandeling en preventie van coronaire hartziekten door verlaging van de serumcholesterolconcentratie; derde consensus 'Cholesterol'

Beteiligte Personen:

Simoons, M L [VerfasserIn]
Casparie, A F [VerfasserIn]

Themen:

97C5T2UQ7J
Anticholesteremic Agents
Cholesterol
Consensus Development Conference
English Abstract
Guideline
Journal Article
Review

Anmerkungen:

Date Completed 24.02.1999

Date Revised 21.11.2013

published: Print

ErratumIn: Ned Tijdschr Geneeskd 1998 Oct 3;142(40):2232

Citation Status MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM097929492