Fw: News release from UT Southwestern May 15, 2001

[Guest guest]

Hi Ladies,

Since many of us have much difficulty with out-of-whack cholestral &

triglyceride readings, I thought this would be of interest.

Blessings,

MM / NSIF

Martha Murdock, Director

National Silicone Implant Foundation

Dallas, Texas Headquarters

----- Original Message -----

From: " Robin Amerine " <Robin.Amerine@...>

<UTSWNEWS@...>

Sent: Tuesday, May 15, 2001 8:23 AM

Subject: News release from UT Southwestern May 15, 2001

Media Contact: Theresa Merola

214-648-3404

theresa.merola@...

Amy Shields

amy.shields@...

NEW CHOLESTEROL GUIDELINES EXPECTED TO LEAD TO A TRIPLING OF AMERICANS

TAKING CHOLESTEROL-LOWERING DRUGS

DALLAS - May 16, 2001 - A panel of the nation's top cholesterol experts

convened by the National Heart, Lung and Blood Institute (NHLBI) has issued

new guidelines focusing on preventing coronary heart disease, which is

expected to lead to more than 35 million Americans, three times as many as

currently, taking cholesterol-lowering medication and more than 65 million

following a new recommended diet.

Dr. Grundy, director of the Center for Human Nutrition at UT

Southwestern Medical Center at Dallas, chaired the National Cholesterol

Education Program Expert Panel on Detection, Evaluation and Treatment of

High Blood Cholesterol in Adults (Adult Treatment Panel III), the executive

summary of which is published in today's Journal of the American Medical

Association. Grundy also chaired the NCEP Adult Treatment Panel II, which

issued the last cholesterol guidelines in 1993.

" The new guidelines are expected to substantially increase the number of

Americans being treated for high cholesterol, " said Dr. Claude Lenfant,

director of the NHLBI. " If these guidelines are followed, about 65 million

adults will be on dietary treatment and about 36 million will be prescribed

a cholesterol-lowering drug. "

The report includes several important new features:

· A major focus on identifying people who have multiple risk factors for

coronary heart disease.

· More aggressive cholesterol-lowering treatment for people at high risk.

· Modifications of low HDL (high-density lipoprotein) and triglyceride

classification to better identify people at risk for heart disease.

· New dietary and lifestyle recommendations to enhance both LDL lowering and

other risk factors.

· Identification of the metabolic syndrome as an enhancer of risk beyond

elevated LDL cholesterol.

The report reaffirms that elevated LDL is a major cause of coronary heart

disease and LDL-lowering therapy significantly reduces that risk.

Coronary heart disease (CHD) is the No. 1 killer of Americans, claiming

about 500,000 lives yearly. Studies have consistently shown that by lowering

LDL levels, risk for coronary heart disease is reduced by as much as 40

percent. Those at highest risk for heart attack include those with heart

disease; however, other conditions confer as high a risk for heart attack as

having heart disease itself. These conditions include the presence of

atherosclerosis in other arteries, diabetes and multiple risk factors. These

risk factors include cigarette smoking, hypertension, low HDL, family

history, or age (men over 45 or women over 55).

For this reason, the panel recommends that adults 20 and over have their

total cholesterol, LDL, HDL and triglyceride levels evaluated once every

five years.

Low HDL is now defined as less than 40 milligrams per deciliter; the 1993

report defined low HDL as less than 35 mg/dL. Studies have shown a

significant link between low HDL levels and an increased risk of heart

disease. A higher HDL level, above 60 mg/dL, is considered a " negative " risk

factor and is protective against heart disease.

" The aggressive management and treatment of high blood cholesterol leads to

significant improvement, " said Grundy.

" ATP III maintains attention on intensive treatment of patients with CHD.

But it also adds a new feature. The new focus is on prevention of coronary

heart disease in persons with

multiple risk factors. Many of these persons are at high risk and deserve

more intensive intervention than recommended in ATP II, " Grundy said.

In some individuals a change in lifestyle and eating patterns can have a

powerful effect on lowering LDL, Grundy said.

Today's report recommends " therapeutic lifestyle changes " (TLC), which have

four components:

· The TLC diet, which replaces the Step I and Step II diets, reduces intake

of saturated fats to less than 7 percent of total calories and dietary

cholesterol intake to less than 200 mg per day. Reducing saturated fats and

cholesterol will lower LDL.

· LDL lowering can be enhanced by consuming 2 grams of either plant stanols

or sterols, which are found in certain margarines and salad dressings,

and/or 10 to 25 grams of soluble fiber each day. Fruits, oats, barley and

legumes contain high concentrations of soluble fiber. " It is possible to

double LDL lowering by these latter recommendations. " Grundy said. " These

new approaches to dietary treatment of LDL represent a major new feature of

ATP III. "

· Weight reduction. The report defines abdominal obesity as a waist

circumference of more than 40 inches in men and more than 35 inches in

women. " Overweight and obesity are recognized as major, underlying risk

factors for coronary heart disease*weight reduction will enhance LDL

lowering and will reduce other risk factors as well, " the panel said.

· Increased physical activity, which improves HDL.

A new area of emphasis for the ATP III is the metabolic syndrome, which

occurs in one-fourth of Americans. It consists of a constellation of risk

factors that include overweight and obesity, high triglycerides (200 mg/dL

or greater), low HDL, high blood pressure, high blood glucose and a tendency

to form blood clots. The panel identifies these people as candidates for

intensified therapeutic lifestyle changes.

" The metabolic syndrome has emerged as being as strong a contributor to

early heart disease as cigarette smoking, " Grundy said. " In addition, the

insulin resistance that goes along with the syndrome is one of the

underlying causes of Type II diabetes (non-insulin dependent diabetes

mellitus). It's thus very important to recognize the syndrome and treat it

with lifestyle changes. "

The ATP III also advises against use of hormone-replacement therapy as an

alternative to cholesterol-lowering drugs. Clinical trials have failed to

show that the use of estrogen reduces a woman's risk for heart disease,

Grundy said.

The first Adult Treatment Panel report, published in 1988, focused on the

prevention of CHD, before any signs of clinical disease. The report

identified LDL cholesterol as the primary target of therapy and emphasized

clinical management of patients with higher levels of LDL. In the second

report, published in 1993, the panel reaffirmed the importance of treating

high LDL cholesterol to prevent the development of CHD. It also outlined an

intensive plan to manage LDL cholesterol in people who already have heart

disease.

" In a perfect world, everyone would have low cholesterol, " said panel member

Dr. Margo Denke, associate professor of internal medicine at UT

Southwestern, and an investigator in the Center for Human Nutrition.

" In this third panel, we tried to more carefully define who is most at risk

of coronary heart disease, " Denke said.

Twenty-seven experts in the fields of heart disease, lipid measurement and

management, primary-care medicine, nutrition, epidemiology, health economics

and other areas developed the guidelines over 20 months. The National Heart,

Lung and Blood Institute, part of the National Institutes of Health,

established the National Cholesterol Education Program in 1985.

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This news release is available on our World Wide Web home page at

http://www.utsouthwestern.edu/home_pages/news/