Lowering the Blood Total Cholesterol Level to Prevent Coronary Heart Disease (1993)
RECOMMENDATIONS
- There is insufficient evidence for the inclusion or exclusion of universal screening for hypercholesterolemia in a periodic health examination. None the less, case-finding through repeated measurements of the nonfasting blood total cholesterol levsl should be considered in men 30 to 59 years of age. Individual clinical judgement on whether testing is appropriate should be exercised in all other circumstances.
- There is fair evidence to recommend a diet to progressively reduce the intake of saturated fat and cholesterol and eliminate excess total energy intake (a fat-modified diet) for men aged 30 to 59 years with a total cholesterol level of more than 6.85 mmol/L or an LDL-C level of more than 4.90 mmol/L. If the response is inadequate (as defined by a total cholesterol level of more than 4.50 mmol/L) a cholesterol-lowering drug should be added. In most instances, dietary therapy should be continued for at least 6 months before drug treatment is considered.
- There is insufficient evidence to include or exclude a fat-modified diet, with or without drug therapy, in the routine care of children, men less than 30 or more than 59 years or age and women with a total cholesterol level of more than 6.85 mmol/L or an LDL-C level of more than 4.90 mmol/L.
- There is fair evidence to include general dietary advice on lowering the total fat, saturated fat and cholesterol intake in the routine care of men aged 30 to 69 years.
- There is insufficient evidence to include or exclude such advice in the routine care of children, men less than 30 or more than 69 years or age and women.