This series of fact sheets is based on the work of the current U.S. Preventive Services Task Force (USPSTF). The USPSTF systematically reviews the evidence of effectiveness of a wide range of clinical preventive services—including screening, counseling, and chemoprevention (the use of medication to prevent diseases)—to develop recommendations for preventive care in the primary care setting.
This fact sheet presents highlights of USPSTF recommendations on this topic and should not be used to make treatment or policy decisions. More detailed information on this subject is available from the USPSTF.
Select for PDF version (27 KB). PDF Help.
Lipid disorders are abnormal levels of cholesterol in the blood that put men and women at risk for heart disease.
Some cholesterol is necessary to maintain cell membranes and other aspects of health. However, too much cholesterol can lead to heart disease.
Heart disease is the leading cause of death in the United States. Heart attacks kill nearly 500,000 men and women each year.
Cholesterol is carried through the blood bound to two types of "lipoproteins." Low-density lipoprotein (LDL) carries most of the cholesterol in the blood. High levels of LDL can cause cholesterol to deposit in blood vessels, clogging the arteries.
High-density lipoprotein (HDL) helps remove cholesterol from the blood and helps prevent cholesterol from building up.
The risk for heart disease increases as levels of LDL increase and as levels of HDL decrease.
Lipid disorders are risk factors for heart disease, the leading cause of death in the United States.
The third U.S. Preventive Services Task Force (USPSTF) recommends that:
The third USPSTF makes no recommendation for or against routine cholesterol screening in young adult men and women who are not at risk for heart disease.
Heart disease may be the first sign of abnormal cholesterol levels. Screening can detect cholesterol abnormalities and lead to treatment before heart disease develops or worsens.
Screening can detect cholesterol abnormalities before heart disease develops or worsens.
Several large studies have shown that patients who took cholesterol-lowering drugs for 5-7 years and had either high total cholesterol or low HDL cholesterol decreased their risk of heart disease by about 30 percent. In the one study that included women, the treatment appeared to be as effective in postmenopausal women as in men.
Reducing dietary saturated fat and losing weight can lower total and LDL cholesterol as much as 10-20 percent in some men and women. On average, however, most patients achieve reductions in total cholesterol of about 2-6 percent after modifying their lifestyles.
All men aged 35 and older and all women aged 45 and older should be screened routinely for lipid disorders to find out whether their cholesterol levels increase their risk for heart disease. Younger adults should be screened for lipid disorders if they are otherwise at risk for heart disease.
Clinicians should consider overall risk of heart disease in making treatment decisions. Clinicians should counsel all patients about changing their lifestyles (reducing dietary saturated fat, exercising, and losing weight) to improve their lipid levels. Many men and women, especially those at highest risk, may need medications to best control their lipid abnormalities.
Guidelines for treating high cholesterol are available from the National Heart Lung and Blood Institute/National Cholesterol Education Program.
Drug treatment is usually more effective than dietary changes alone for reducing total cholesterol.
For more information on screening and treatment for lipid disorders, contact the following organizations:
American Academy of Family Physicians
11400 Tomahawk Creek Parkway
Leawood, KS 66211-2672
Phone: (913) 906-6000
http://www.aafp.org
American College of Cardiology
Heart House
9111 Old Georgetown Road
Bethesda, MD 20814
Phone: 1-800-253-4636
Fax: (301)897-9745
http://www.acc.org
American College of Physicians/American Society of Internal Medicine
190 N. Independence Mall West
Philadelphia, PA 19106-1572
Phone (customer service):
1-800-523-1546, ext. 2600
http://www.acponline.org
American Heart Association
National Center
7272 Greenville Avenue
Dallas, TX 75231
Phone (customer heart and stroke information): 1-800-AHA-USA1
http://www.americanheart.org
healthfinder®
www.healthfinder.gov
National Heart, Lung, and Blood Institute (NHLBI)/National Cholesterol Education Program
NHLBI Information Center
Attn: Web Site
P.O. Box 30105
Bethesda, MD 20824-0105
Phone: (301) 592-8573
Fax: (301) 592-8563
www.nhlbi.nih.gov/about/ncep/index.htm
National Heart, Lung, and Blood Institute (NHLBI)
The Heart Truth: A National Awareness Campaign for Women About Heart Disease
www.nhlbi.nih.gov/health/hearttruth/index.htm
More detailed information on this subject is available in the Systematic Evidence Review, Summary of the Evidence, and USPSTF Recommendations and Rationale:
Members of the third USPSTF are an independent panel of experts who represent the fields of family medicine, obstetrics-gynecology, pediatrics, nursing, prevention research, and psychology. Members of the third USPSTF are:
|
Alfred O. Berg, M.D., M.P.H., Chair |
Carole Tracy Orleans, Ph.D. |
AHRQ Publication No. APPIP 01-0011
Current as of March 2001
Internet Citation:
Screening Adults for Lipid Disorders. What's New from the USPSTF. AHRQ Publication No. APPIP 01-0011, March 2001. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/prev/lipidwh.htm
Return to Put Prevention Into Practice
U.S. Preventive Services Task Force
Clinical Information
AHRQ Home Page