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Management of Hypercholesterolemia
Geriatrics & Aging, 11/10/09
Aronow WS – The updated National Cholesterol Education Program (NCEP) III guidelines state that in very–high–risk patients, a serum low–density lipoprotein (LDL) cholesterol level of <1.81 mmol/L (<70 mg/dL) correct is a reasonable clinical strategy, regardless of age. When a high–risk person has hypertriglyceridemia or low serum high–density lipoprotein cholesterol, consideration can be given to combining a fibrate or nicotinic acid with an LDL cholesterol–lowering drug. For moderately high–risk persons, the serum LDL cholesterol should be reduced to <2.59 mmol/L 2.59 (<100 mg/dL). When LDL cholesterol–lowering drug therapy is used to treat high–risk persons or moderately high–risk persons, the serum LDL cholesterol should be reduced by at least 30–40%. High–risk older persons should be treated with lipid–lowering drug therapy according to NCEP III updated guidelines to reduce cardiovascular morbidity and mortality. The LDL cholesterol should be reduced to <4.14 mmol/L (<160 mg/dL)correct in persons at low risk for cardiovascular disease.
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