National Cholesterol Education Program recommendations for cholesterol testing in young adults. A science-based approach.

Abstract

The National Cholesterol Education Program (NCEP) recommends that all adults ≥20 years old have their serum cholesterol concentrations measured.1 2 The NCEP guidelines have been endorsed by representatives of more than 40 medical and health organizations, including the American College of Cardiology, American Academy of Family Physicians, American Medical Association, American College of Preventive Medicine, and American Heart Association. A dissent from this recommendation has been registered in a recent report of the American College of Physicians (ACP),3 which maintains that it is not necessary to measure serum cholesterol levels in young adult men (ages 20 to 35 years) and premenopausal women (ages 20 to 45 years) and in older individuals (>65 years old). The arguments against cholesterol measurement in young adults and older patients are restated by Garber and Browner, the authors of the ACP guidelines, in the present issue of Circulation .4 The NCEP is planning to publish a detailed position paper on cholesterol lowering in the elderly population later in 1997. In this article, we outline the NCEP recommendations regarding cholesterol testing in young adults and the scientific rationale for the recommendations. The second report of the NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II [ATP II]) recommends that total cholesterol levels be measured at least once every 5 years in all adults ≥20 years old and that HDL cholesterol levels be measured at the same time if accurate results are available.1 2 These recommendations are based on a large and diverse body of evidence derived from animal, pathological, genetic, biochemical, metabolic, and epidemiological studies and clinical trials, as extensively referenced in the ATP II report.2 The 25 members of ATP II were selected, not as mischaracterized by Garber and Browner4 …