The National Heart, Lung, and Blood Institute (NHLBI) initiated the National Cholesterol Education Program (NCEP) in 1985. The goal was to reduce the number of Americans with elevated cholesterol and thus reduce illnesses and deaths in the United States due to coronary heart disease. Three adult treatment panels have been published since then with clinical practice guidelines for managing cholesterol levels in adults.
Adult Treatment Panel III (ATP III), was published in 2001 and updated in 2004. The NCEP:ATP III also includes criteria for the diagnosis of metabolic syndrome.
In 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) released new guidelines for the treatment of high blood cholesterol. These guidelines were designed to update ATP III.2
Metabolic Syndrome and the ACC/AHA Guidelines
ATP III highlighted the role of metabolic syndrome as a multiplex risk factor for atherosclerotic cardiovascular disease (ASCVD). This importance was subsequently confirmed by AHA and NHLBI and several international organizations. The presence of this syndrome essentially doubles the risk for ASCVD and is a major target for lifestyle intervention. However, ACC/AHA guidelines appear to discount the metabolic syndrome because of a lack of clinical trials that specifically target it with drug therapy. The metabolic syndrome nonetheless remains a major cardiovascular risk factor that needs clinical attention.
