At what levels of total low- or high-density lipoprotein cholesterol should diet/drug therapy be initiated? United States guidelines.
At what levels of total low- or high-density lipoprotein cholesterol should diet/drug therapy be initiated? United States guidelines.
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当低密度脂蛋白胆固醇或高密度脂蛋白胆固醇总量达到什么水平时，应开始饮食/药物治疗？
DOI：
10.1016/0002-9149(90)91247-4
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
J. Larosa
中科院分区：
文献类型：
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作者：
J. Larosa
美国已经制定了成人高胆固醇血症的检测、评估和治疗指南。这些指南建议将总胆固醇水平用于筛查目的。总胆固醇水平 >240 mg/dl 被认为是“高”，200 至 239 mg/dl 被认为是“临界”，而 <200 mg/dl 则被认为是“正常”，无论该人的年龄或性别如何。所有高类别人群以及具有其他危险因素或已确诊血管疾病的边缘类别人群都需要测量低密度脂蛋白 (LDL) 胆固醇水平。低密度脂蛋白胆固醇水平用于指导治疗的选择。 LDL 胆固醇水平 >130 mg/dl 的患者适合积极饮食治疗。饮食治疗 3 至 6 个月后 LDL 胆固醇水平为 160 至 190 mg/dl 的患者适合接受药物治疗。高密度脂蛋白 (HDL) 水平<35 mg/dl 被认为是危险因素，可能会影响开始药物治疗的 LDL 水平。一些观察家担心这些指南过分强调低密度脂蛋白胆固醇，而忽视了总胆固醇、高密度脂蛋白胆固醇和甘油三酯水平。尽管如此，该指南已被广泛接受，目前已成为广泛的公共卫生教育计划的基础。
Guidelines for the detection, evaluation and treatment of hypercholesterolemia in adults have been established in the United States. These guidelines recommend that total cholesterol levels be used for screening purposes. Total cholesterol levels >240 mg/dl are considered “high,” those from 200 to 239 mg/dl “borderline,” and those <200 mg/dl “normal,” regardless of the person's age or gender. All persons in the high category, as well as those in the borderline category who have other risk factors or established vascular disease, require measurements of low-density lipoprotein (LDL) cholesterol levels. LDL cholesterol levels are used to guide the selection of treatment. Patients with LDL cholesterol levels >130 mg/dl are candidates for active diet therapy. Those whose LDL cholesterol levels are 160 to 190 mg/dl after 3 to 6 months of diet therapy are candidates for drug therapy. A high-density lipoprotein (HDL) level <35 mg/dl is considered a risk factor and may influence the level of LDL at which drug therapy is initiated. Some observers have expressed concern that these guidelines overemphasize LDL cholesterol at the expense of total cholesterol, HDL cholesterol and triglyceride levels. Nevertheless, the guidelines have been broadly accepted and currently serve as the basis for a widespread public-health education program.