|
|
Initiate
dietary intervention |
Consider drug
therapy |
LDL-C
goal |
| Without
CHD and less than 2 risk factors* |
>160
mg/dL
|
>190
mg/dL
|
<160
mg/dL
|
| Without
CHD and with 2 or more risk factors |
>130
mg/dL
|
>160
mg/dL
|
<130
mg/dL
|
| With
CHD |
>100
mg/dL
|
>130
mg/dL
|
<100
mg/dL
|
|
•
The National Cholesterol Education Program (NCEP) guidelines1 offer
clinicians a good reference point for considering therapy in patients
with HIV infection and dyslipidemia.
• The guidelines focus on LDL cholesterol. Estimates of LDL
in patients with triglycerides higher than 400 mg/dL, however, may
be unreliable. In such patients, a total cholesterol level greater
than 240 mg/dL or an HDL cholesterol level less than 35 mg/dL requires
dietary intervention initially.
• Risk factors include age 45 and higher for men and age 55
or higher in women or premature menopause without estrogen replacement
therapy. A family history of heart disease in a first-degree male
relative before 55 years of age or a first-degree female relative
before 65 years of age are also risk factors. Other risk factors
are smoking, hypertension, an HDL below 35 mg/dL, and diabetes.
If a patient has a high HDL above 60 mg/dL, one risk factor can
be subtracted.
Reference:
1. National Cholesterol Education Program (NCEP). Second report
of the expert panel on detection, evaluation, and treatment of high
blood cholesterol in adults (Adult Treatment Panel II). Circulation.
1994;89:1329-445.
|
|
