CLINICAL GUIDELINE, PART 1: Guidelines for Using Serum Cholesterol, High-Density Lipoprotein Cholesterol, and Triglyceride Levels as Screening Tests for Preventing Coronary Heart Disease in Adults
Authors: American College of Physicians*
Journal: Annals of Internal Medicine (1996)

Position Papers1 March 1996CLINICAL GUIDELINE, PART 1: Guidelines for Using Serum Cholesterol, High-Density Lipoprotein Cholesterol, and Triglyceride Levels as Screening Tests for Preventing Coronary Heart Disease in AdultsAmerican College of Physicians*American College of Physicians*Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-5-199603010-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail AbstractThe numbers in square brackets are cross references to the numbered paragraphs in the accompanying paper, "Cholesterol Screening in Asymptomatic Adults, Revisited" (see pages 518-531).References1. Garber AM, Browner WS, Hulley SB. Cholesterol screening in asymptomatic adults, revisited. Ann Intern Med. 1996; 124:518-31. Google Scholar2. Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. The Expert Panel. Arch Intern Med. 1988; 148:36-69. Google Scholar3. National Cholesterol Education Program. The Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). Bethesda, MD: National Institutes of Health; 1993. Google Scholar4. Canadian Consensus Conference on Cholesterol: final report. The Canadian Consensus Conference on the Prevention of Heart and Vascular Disease by Altering Serum Cholesterol and Lipoprotein Risk Factors. Can Med Assoc J. 1988; 139(11 Suppl):1-8. Google Scholar5. Eddy DM, ed. Common Screening Tests. Philadelphia: American College of Physicians; 1991. Google Scholar6. Asymptomatic hypercholesterolemia: a clinical policy review. The Toronto Working Group on Cholesterol Policy. J Clin Epidemiol. 1990; 43:1028-121. Google Scholar7. Periodic health examination, 1993 update: 2. Lowering the blood total cholesterol level to prevent coronary heart disease. Canadian Task Force on the Periodic Health Examination. Can Med Assoc J. 1993; 148:521-38. Google Scholar8. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force. 2d ed. Baltimore: Williams & Wilkins; 1995. Google Scholar Author, Article, and Disclosure InformationAffiliations: *These guidelines were authored by Alan M. Garber, MD, PhD, and Warren S. Browner, MD, and were developed for the Health and Public Policy Committee by the Clinical Efficacy Assessment Subcommittee: Ernest L. Mazzaferri, MD, Chair; John R. Feussner, MD; Gerald R. Kerby, MD; Gottlieb C. Friesinger II, MD; Keith I. Marton, MD; Alvin I. Mushlin, MD; Valerie Anne Palda, MD; and George E. Thibault, MD; and by the Educational Policy Committee: Harold Sox, MD, Chair; John Barker Jr., MD; Ian Hart, MD;Lawrence Blonde, MD; Ernest L. Mazzaferri, MD; Laura Carravallah, MD; John Noble, MD; F. Daniel Duffy, MD; Arthur Feinberg, MD; Eleanor Wallace, MD; Sandra Fryhofer, MD; and Herbert Waxman, MD. The guidelines were approved by the Board of Regents on 20 March 1995.Corresponding Author: Department of Scientific Policy, American College of Physicians, Independence Mall West, Sixth Street at Race, Philadelphia, PA 19106-1572. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCLINICAL GUIDELINE, PART 2: Cholesterol Screening in Asymptomatic Adults, Revisited Alan M. Garber , Warren S. Browner , and Stephen B. Hulley Cholesterol Agonistics John C. LaRosa Evangelists and Snails Redux: The Case of Cholesterol Screening Frank Davidoff Metrics Cited byRole of Rare and Low-Frequency Variants in Gene-Alcohol Interactions on Plasma Lipid LevelsReprint of "Influence of analytical bias and imprecision on the number of false positive results using Guideline-Driven Medical Decision Limits"Influence of analytical bias and imprecision on the number of false positive results using Guideline-Driven Medical Decision LimitsLifestyle Strategies for Risk Factor Reduction, Prevention and Treatment of Coronary Artery DiseaseUpdate on guidelines for management of hypercholesterolemiaDeveloping predictive CSF biomarkers—A challenge critical to success in Alzheimer's disease and neuropsychiatric translational medicineSimilar cardiovascular risk factor profile in screen-detected and known type 2 diabetic subjectsElder care: Immunization schedules and screening after age 65 yearsCost Effectiveness and Screening Interval of Lipid Screening in Hodgkin's Lymphoma SurvivorsWhen high is low: Raising low levels of high-density lipoprotein cholesterolDesempenho da solicitação do perfil lipídico entre os setores público e privadoLipids, statins and cardiovascular diseaseDistribution of Abdominal Adiposity and Cardiovascular Risk Factors in Yaquis Indians from Sonora, MéxicoModelling effectiveness of internally heterogeneous organizations in the presence of survey non-response: an application to the ULTRA studyLifestyle Medicine Strategies for Risk Factor Reduction, Prevention, and Treatment of Coronary Heart Disease: Part IIGender-specific characteristics of atherosclerosis in menopausal women: risk factors, clinical course and strategies for preventionCardiovascular Disease Risk Perception and KnowledgeDyslipidemiaIncrease in aortic pulse wave velocity is associated with abnormal postprandial triglyceride responseRisk for Coronary Artery Disease and Morbid Preeclampsia: A CommentaryCommunity-based multiple screening modelManagement of dyslipidemias in the age of statinsCharacteristics and Lipid Distribution of a Large, High-Risk, Hypertensive Population: The Lipid-Lowering Component of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)Health Screening Decisions for Older Adults: AGS Position PaperPreventionClinical PreventionClinical PreventionJustifying lipid-lowering therapy in persons ≥65 years of ageWhat do the statins tell us?Preventive health care for older patientsShould the guidelines for monitoring serum cholesterol levels in the elderly be re-evaluated?Primary prevention of diseases of old ageGuest Editorial: Should Hypercholesterolemia in Older Persons Be Treated to Reduce Cardiovascular Events?Unanswered Questions: The Use of Statins in Older People to Prevent Cardiovascular Event Effects of Statins on Risk of Coronary Disease: A Meta‐Analysis of Randomized Controlled TrialsDisease Prevention Guidelines from the U.S. Preventive Services Task ForceHarold C. Sox, MD, EditorDetection of Subclinical Cardiovascular Disease: The Emerging Role of Electron Beam Computed TomographyYield and Cost of Individual Common Diagnostic Tests in New Primary Care Outpatients in JapanDisparities in Cholesterol Screening: Falling Short of a National Health ObjectiveTreatment of Isolated Systolic Hypertension Is Most Effective in Older Patients With High-Risk ProfilePrevention and Treatment of Coronary Heart DiseaseLooking Forward at AnnalsHarold Sox, MD, EditorControversial issues in climacteric medicine (I) Cardiovascular disease and hormone replacement therapy. International Menopause Society Expert Workshop, 13–16 October 2000, Royal Society of Medicine, London, UKControversies in the Treatment of Hypercholesterolemia in the Elderly: Who Should Be Treated and How?Screening and treating adults for lipid disorders21Reprints are available from the AHRQ Web site at www.ahrq.gov/clinic/uspstfix.htm, through the National Guideline Clearinghouse (www.guideline/gov), or in print through the AHRQ Publications Clearinghouse (1-800-358-9295).22The USPSTF recommendations based on this evidence review can be found in Screening Adults for Lipid Disorders: Recommendations and Rationale, available elsewhere in this supplement and from the AHRQ Web site and clearinghouse.Screening adults for lipid disordersRisk Factors for Coronary Heart Disease in Men 18 to 39 Years of AgeElena L. Navas-Nacher, MS, Laura Colangelo, MS, Craig Beam, PhD, and Philip Greenland, MDManagement of hyperlipidemia in childrenHYPERLIPIDEMIAHigh-density lipoprotein and coronary heart disease – an updateOpportunistic Discovery of Occult Disease by Use of Test Panels in New, Symptomatic Primary Care Outpatients: Yield and Cost of Case FindingAssociation of Coronary Heart Disease Risk Factors With Microscopic Qualities of Coronary Atherosclerosis in YouthIs Hypercholesterolemia a Risk Factor and Should it Be Treated in the Elderly?Blood cholesterol screeningQuality Enhancement Research Initiative in Ischemic Heart DiseaseUsing Cost-Effectiveness Analysis To Target Cholesterol ReductionAlan M. Garber, MD, PhDRaising low levels of high-density lipoprotein cholesterol is an important target of therapyMarkers of inflammation as predictors in cardiovascular diseasePrevention of coronary heart diseaseCalidad del tratamiento farmacológico en pacientes con hiperlipemia de 4 áreas de saludCardiovascular disease and hormone replacement therapyLipid Lowering Strategies in WomenSCREENING FOR CARDIOVASCULAR DISEASESerum Cholesterol Levels in College Students: Opportunities for Education and InterventionThe Role of Dietary Fat in Child Nutrition and Development: Summary of an ASNS WorkshopThe relative influence of secondary versus primary prevention using the National Cholesterol Education Program Adult Treatment Panel II guidelinesMiddle-aged men at high risk of cardiovascular disease: the west of scotland coronary prevention studyYoung adults with hypercholesterolemiaPrevention of cardiovascular events in elderly hypercholesterolemic patientsEvaluation and management of lipid disordersACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina11This document was approved by the American College of Cardiology Board of Trustees in March 1999, the American Heart Association Science Advisory and Coordinating Committee in March 1999, and the American College of Physicians-American Society of Internal Medicine Board of Regents in February 1999.When citing this document, please use the following citation format: Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM, Grunwald MA, Levy D, Lytle BW, O'Rourke RA, Schafer WP, Williams SV. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina). J Am Coll Cardiol 1999;33:2092–197.This document is available on the World Wide Web sites of the American College of Cardiology (www.acc.org) and the American Heart Association (www.americanheart.org). Reprints of this document are available by calling 1-800-253-4636 or writing the American College of Cardiology, Educational Services, at 9111 Old Georgetown Road, Bethesda, MD 20814-1699. Ask for reprint number 71-0166. To obtain a reprint of the Executive Summary and Recommendations published in the June 1, 1999 issue of Circulation, ask for reprint number 71-0167. To purchase bulk reprints (specify version and reprint number): Up to 999 copies call 1-800-611-6083 (US only) or fax 413-665-2671; 1000 or more copies call 214-706-1466, fax 214-691-6342, or e-mail [email protected]A population-based treat-to-target pharmacoeconomic analysis of HMG-CoA reductase inhibitors in hypercholesterolemiaAssessing the appropriateness of coronary revascularization: The university of maryland revascularization appropriateness score (ras) and its comparison to rand expert panel ratings and american college of cardiology/american heart association guidelines with regard to assigned appropriateness rating and ability to predict outcomeReflex testing I: Algorithm for lipid and lipoprotein measurement in coronary heart disease risk assessmentSystematic Review on the Risk and Benefit of Different Cholesterol-Lowering InterventionsLipoproteins and ApoproteinsMetaanálisis, megaensayos y práctica clínica en cardiologíaTriglycerides as a risk factor for coronary artery diseaseThe role of screening blood tests in patients with arterial disease attending vascular outpatientsSerum Lipid Physiology and the Influence of Glaucoma MedicationsScience, Policy, and Controversy in the Cholesterol ArenaDeterminants of cholesterol screening and treatment patternsSelective Opportunistic Screening for Hypercholesterolemia in Primary Care PracticeDETECTION AND EVALUATION OF DYSLIPOPROTEINEMIATHE ROLE OF CHOLESTEROL MANAGEMENT IN CORONARY DISEASE RISK REDUCTION IN ELDERLY PATIENTSIschemic heart diseaseUnderutilization of Measurement of Serum Low-Density Lipoprotein Cholesterol Levels and of Lipid-Lowering Therapy in Older Patients with Manifest Atherosclerotic DiseaseThe American College of Physicians guidelines for screening blood cholesterol levels: a commentaryPrimary prevention of coronary diseasePrimary Prevention of Coronary Heart Disease: Guidance From FraminghamImpact of receiving blood cholesterol test results on dietary changeCARDIOVASCULAR DISEASES IN WOMENCholesterol Awareness After Case-Finding: Do Patients Really Know Their Cholesterol Numbers?Cholesterol Screening GuidelinesNational Cholesterol Education Program Recommendations for Cholesterol Testing in Young AdultsCholesterol Screening GuidelinesBaseline Risk Factors and their Association With Outcome in the West of Scotland Coronary Prevention StudyPreventive Medicine and Screening in Older AdultsLipids and Lipoproteins in WomenCholesterol screening should be targetedEuphenic Prevention of Coronary Artery DiseaseEl futuro de la cardiología en España a partir de la evolución en los últimos 30 añosEffects of Serum Lipoproteins and Smoking on Atherosclerosis in Young Men and WomenNational Dairy Council Award for Excellence in Medical/Dental Nutrition Education Lecture, 1996: nutrition education--success or failure?General internal medicine updatePrimary prevention — Have we gone too far?The American College of Physicians Versus the National Cholesterol Education Program: Should Endocrinologists Listen?Rational approach to pharmacologic reduction of cholesterol levels in childrenHyperlipidemiaStatins and coronary heart diseaseCHD in the elderly: Knowledge for clinicians and researchersTrends in cholesterol testing in general practice 1 March 1996Volume 124, Issue 5Page: 515-517KeywordsCholesterolClinical trialsCoronary heart diseaseHigh density lipoproteinHypercholesterolemiaLow density lipoproteinMedical risk factorsPrimary hypertensionResearch laboratoriesSpecimen preparation and treatment ePublished: 15 August 2000 Issue Published: 1 March 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. 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