Coronary heart disease (CHD) is the leading cause of morbidity and mortality in the United States. A direct relationship has been demonstrated between dyslipidemia and the risk for developing CHD. Improving lipid status has been clearly demonstrated to reduce the morbidity and mortality associated with lipid disorders. The recently published National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines and revised Health Plan Employer Data and Information Set (HEDIS) performance measures have placed added emphasis on screening and treatment of lipid disorders and global risk for CHD. Current ATP III and HEDIS cholesterol screening and goal measures are targeting more Americans for cholesterol-lowering therapy. This review summarizes the implications of the HEDIS performance measures and the ATP III guidelines, reviews the economic benefits of lowering cholesterol, and identifies optimal cholesterol levels. In addition, the challenges associated with patients who have suboptimal control and patients with poor compliance are discussed, as these factors significantly increase CHD morbidity, mortality, and cost of disease. In addition, lipid-lowering drug therapies are reviewed, and a lipid-lowering agent currently in phase 3 development, rosuvastatin, is introduced.
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