This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

The Expert Panel; DeWitt S. Goodman, MD; Stephen B. Hulley, MD, MPH; Luther T. Clark, MD; C. E. Davis, PhD; Valentin Fuster, MD; John C. LaRosa, MD; Albert Oberman, MD; Ernst J. Schaefer, MD; Daniel Steinberg, MD, PhD; W. Virgil Brown, MD; Scott M. Grundy, MD, PhD; Diane Becker, RN, MPH, ScD; Edwin Bierman, MD; Jacqueline Sooter-Bochenek, RD, MS; Rebecca Mullis, RD, PhD; Neil Stone, MD; Donald B. Hunninghake, MD; Jacqueline M. Dunbar, RN, PhD; Henry N. Ginsberg, MD; D. Roger Illingworth, MD, PhD; Harold C. Sadin, MD; Gustav Schonfeld, MD; James I. Cleeman, MD; H. Bryan Brewer, Jr, MD; Nancy Ernst, MS, RD; William Friedewald, MD; Jeffrey M. Hoeg, MD; Basil Rifkind, MD; David Gordon, MD, PhD

Arch Intern Med. 1988;148(1):36-69.

Abstract
• This report of an expert panel of the National Cholesterol Education Program provides new guidelines for the treatment of high blood cholesterol in adults 20 years of age and over. Total cholesterol levels are classified as follows: <200 mg/dL —"desirable blood cholesterol"; 200 to 239 mg/dL—borderline—high blood cholesterol; 240 mg/dL—high blood cholesterol. The guidelines detail which patients should go on to have lipoprotein analysis, and which should receive cholesterol-lowering treatment on the basis of their low density lipoprotein (LDL)—cholesterol levels and status with respect to other coronary heart disease risk factors. Dietary therapy is the primary cholesterol-lowering treatment. The report specifies the LDL-cholesterol levels at which dietary therapy should be started and the goals of therapy, and provides detailed guidance on the nature of the recommended dietary changes. If, after six months of intensive dietary therapy, LDL-cholesterol exceeds specified levels, drug treatment should be considered.

(Arch Intern Med 1988;148:36-69)

Author Affiliations
Prevalence, Detection, Diagnosis, and Evaluation Subcommittee.; Diet Treatment Subcommittee; Drug Treatment Subcommittee

From the National Cholesterol Education Program, National Heart, Lung, and Blood Institute, Bethesda, Md.

Footnotes
Accepted for publication Sept 28, 1987.

Reprint requests to Coordinator, National Cholesterol Education Program, National Heart, Lung, and Blood Institute, Bldg 31, Room 4A 05, Bethesda, MD 20892 (Dr Cleeman).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Simplifying the Approach to the Management of Dyslipidemia
Gaziano and Gaziano
JAMA 2009;302:2148-2149.
FULL TEXT  

Low-Density Lipoprotein Cholesterol Reduction and Prevention of Cardiovascular Disease
Stein
Mayo Clin Proc. 2009;84:307-309.
FULL TEXT  

The Multiple Risk Factor Intervention Trial (MRFIT)--Importance Then and Now
Stamler and Neaton
JAMA 2008;300:1343-1345.
FULL TEXT  

Re-Evaluating Therapeutic Target Goals for Statin-Treated Patients: Time for Revolutionary Changes?
Henkin
J Am Coll Cardiol 2008;52:633-635.
FULL TEXT  

Lipids, Apolipoproteins, and Their Ratios in Relation to Cardiovascular Events With Statin Treatment
Kastelein et al.
Circulation 2008;117:3002-3009.
ABSTRACT | FULL TEXT  

Lipid Management to Reduce Cardiovascular Risk: A New Strategy Is Required
Superko and King
Circulation 2008;117:560-568.
FULL TEXT  

Assessing Mature Technology: What Is the Effect of High-Quality Risk Stratification Evidence With Exercise Echocardiography and Single-Photon Emission Computed Tomography Imaging?
Shaw et al.
J Am Coll Cardiol 2007;49:238-239.
FULL TEXT  

Clinical outcome of older patients with acute coronary syndrome over the last three decades.
Tang et al.
Age Ageing 2006;35:280-285.
ABSTRACT | FULL TEXT  

Patients' Perceptions of Cholesterol, Cardiovascular Disease Risk, and Risk Communication Strategies
Goldman et al.
Ann Fam Med 2006;4:205-212.
ABSTRACT | FULL TEXT  

What's New? Guidelines and Goals
Wigle and Birtcher
Journal of Pharmacy Practice 2006;19:103-112.
ABSTRACT  

REVIEW: Efficacy and Mechanisms of Action of Statins in the Treatment of Diabetic Dyslipidemia
Ginsberg
J. Clin. Endocrinol. Metab. 2006;91:383-392.
ABSTRACT | FULL TEXT  

Thematic review series: The Pathogenesis of Atherosclerosis. An interpretive history of the cholesterol controversy, part IV: The 1984 Coronary Primary Prevention Trial ends it--almost
Steinberg
J. Lipid Res. 2006;47:1-14.
ABSTRACT | FULL TEXT  

Treatment with high-dose simvastatin reduces secretion of apolipoprotein B-lipoproteins in patients with diabetic dyslipidemia
Myerson et al.
J. Lipid Res. 2005;46:2735-2744.
ABSTRACT | FULL TEXT  

Managing Abnormal Blood Lipids: A Collaborative Approach
Fletcher et al.
Circulation 2005;112:3184-3209.
ABSTRACT | FULL TEXT  

"Doctor, Is My Sugar Normal?"
Arky
NEJM 2005;353:1511-1513.
FULL TEXT  

Comparison of the Instructional Efficacy of Internet-Based CME With Live Interactive CME Workshops: A Randomized Controlled Trial
Fordis et al.
JAMA 2005;294:1043-1051.
ABSTRACT | FULL TEXT  

Awareness and Treatment of Dyslipidemia in Young Adults With Type 1 Diabetes
Wadwa et al.
Diabetes Care 2005;28:1051-1056.
ABSTRACT | FULL TEXT  

Increased ApoB in Small Dense LDL Particles Predicts Premature Coronary Artery Disease
Brunzell
Arterioscler. Thromb. Vasc. Bio. 2005;25:474-475.
FULL TEXT  

Has Control of Hypercholesterolemia and Hypertension in Type 1 Diabetes Improved Over Time?
Zgibor et al.
Diabetes Care 2005;28:521-526.
ABSTRACT | FULL TEXT  

Serum Lipid Concentrations and Prevalence of Dyslipidemia in a Large Professional Population in Beijing
Li et al.
Clin. Chem. 2005;51:144-150.
ABSTRACT | FULL TEXT  

The Canadian Experience: Why Canada Decided Against an Upper Limit for Cholesterol
McDonald
J. Am. Coll. Nutr. 2004;23:616S-620S.
ABSTRACT | FULL TEXT  

The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial
Aude et al.
Arch Intern Med 2004;164:2141-2146.
ABSTRACT | FULL TEXT  

The case for statins: has it really been made?
Thompson and Temple
JRSM 2004;97:461-464.
FULL TEXT  

Clinical Chemistry Journal Has Contributed to Progress in Lipid and Lipoprotein Testing for Fifty Years
Rifai et al.
Clin. Chem. 2004;50:1861-1870.
FULL TEXT  

The Relative Impact of Inadequate Primary and Secondary Prevention on Cardiovascular Mortality in the United States
Qureshi et al.
Stroke 2004;35:2346-2350.
ABSTRACT | FULL TEXT  

The Cardiovascular Risk of Young Women with Polycystic Ovary Syndrome: An Observational, Analytical, Prospective Case-Control Study
Orio et al.
J. Clin. Endocrinol. Metab. 2004;89:3696-3701.
ABSTRACT | FULL TEXT  

Effects of low and moderate exercise intensity on postprandial lipemia and postheparin plasma lipoprotein lipase activity in physically active men
Katsanos et al.
J. Appl. Physiol. 2004;96:181-188.
ABSTRACT | FULL TEXT  

Opposite Changes in Circulating Adiponectin in Women With Bulimia Nervosa or Binge Eating Disorder
Monteleone et al.
J. Clin. Endocrinol. Metab. 2003;88:5387-5391.
ABSTRACT | FULL TEXT  

Aggressive Lipid Management for Cardiovascular Prevention: Evidence from Clinical Trials
Friday
Exp. Biol. Med. 2003;228:769-778.
ABSTRACT | FULL TEXT  

Measurement of cholesterol of major serum lipoprotein classes by anion-exchange HPLC with perchlorate ion-containing eluent
Hirowatari et al.
J. Lipid Res. 2003;44:1404-1412.
ABSTRACT | FULL TEXT  

Locus on Chromosome 6p Linked to Elevated HDL Cholesterol Serum Levels and to Protection Against Premature Atherosclerosis in a Kindred With Familial Hypercholesterolemia
Canizales-Quinteros et al.
Circ. Res. 2003;92:569-576.
ABSTRACT | FULL TEXT  

References
Circulation 2002;106:3373-3421.
FULL TEXT  

Evolving concepts and a new approach for management of hyperlipidemia
Ballantyne
Eur Heart J Suppl 2002;4:J1-J3.
ABSTRACT  

Effects of atorvastatin on the HDL subpopulation profile of coronary heart disease patients
Asztalos et al.
J. Lipid Res. 2002;43:1701-1707.
ABSTRACT | FULL TEXT  

Fatty acids differentially regulate hepatic cholesteryl ester formation and incorporation into lipoproteins in the liver of the mouse
Xie et al.
J. Lipid Res. 2002;43:1508-1519.
ABSTRACT | FULL TEXT  

Treating to goal: new strategies for initiating and optimizing lipid-lowering therapy in patients with atherosclerosis
Fonarow
Vasc Med 2002;7:187-194.
ABSTRACT  

Cardiovascular Consequences of Early-Onset Growth Hormone Excess
Colao et al.
J. Clin. Endocrinol. Metab. 2002;87:3097-3104.
ABSTRACT | FULL TEXT  

Disparities in the Diagnosis and Pharmacologic Treatment of High Serum Cholesterol by Race and Ethnicity: Data From the Third National Health and Nutrition Examination Survey
Nelson et al.
Arch Intern Med 2002;162:929-935.
ABSTRACT | FULL TEXT  

A Community-Wide Survey of Physician Practices and Attitudes Toward Cholesterol Management in Patients With Recent Acute Myocardial Infarction
Yarzebski et al.
Arch Intern Med 2002;162:797-804.
ABSTRACT | FULL TEXT  

Lipoprotein Profile in Subclinical Hypothyroidism: Response to Levothyroxine Replacement, a Randomized Placebo-Controlled Study
Caraccio et al.
J. Clin. Endocrinol. Metab. 2002;87:1533-1538.
ABSTRACT | FULL TEXT  

Lipids and Atherosclerosis: Lessons Learned from Randomized Controlled Trials of Lipid Lowering and Other Relevant Studies
Kreisberg and Oberman
J. Clin. Endocrinol. Metab. 2002;87:423-437.
FULL TEXT  

Impact of the Third Cholesterol Report from the Adult Treatment Panel of the National Cholesterol Education Program on the Clinical Laboratory
Warnick et al.
Clin. Chem. 2002;48:11-17.
ABSTRACT | FULL TEXT  

Major risk factors and coronary heart disease: much has been achieved but crucial challenges remain
Daviglus and Stamler
J Am Coll Cardiol 2001;38:1018-1022.
FULL TEXT  

Later management of documented ischaemic heart disease: secondary prevention and rehabilitation
McLeod
Br Med Bull 2001;59:113-133.
ABSTRACT | FULL TEXT  

Influence of Intensive Diabetes Treatment on Body Weight and Composition of Adults With Type 1 Diabetes in the Diabetes Control and Complications Trial
The Diabetes Control and Complications Trial Resea
Diabetes Care 2001;24:1711-1721.
ABSTRACT | FULL TEXT  

Evolution of Methods for Measurement of HDL-Cholesterol: From Ultracentrifugation to Homogeneous Assays
Warnick et al.
Clin. Chem. 2001;47:1579-1596.
ABSTRACT | FULL TEXT  

Antioxidant Supplements Block the Response of HDL to Simvastatin-Niacin Therapy in Patients With Coronary Artery Disease and Low HDL
Cheung et al.
Arterioscler. Thromb. Vasc. Bio. 2001;21:1320-1326.
ABSTRACT | FULL TEXT  

Ineffective Secondary Prevention in Survivors of Cardiovascular Events in the US Population: Report From the Third National Health and Nutrition Examination Survey
Qureshi et al.
Arch Intern Med 2001;161:1621-1628.
ABSTRACT | FULL TEXT  

Enhanced Susceptibility to Oxidation and Diminished Vitamin E Content of LDL from Patients with Stable Coronary Artery Disease
Haidari et al.
Clin. Chem. 2001;47:1234-1240.
ABSTRACT | FULL TEXT  

Temporal Trends (1986-1997) in Cholesterol Level Assessment and Management Practices in Patients With Acute Myocardial Infarction: A Population-Based Perspective
Yarzebski et al.
Arch Intern Med 2001;161:1521-1528.
ABSTRACT | FULL TEXT  

Non-High-Density Lipoprotein Cholesterol Level as Potential Risk Predictor and Therapy Target
Grundy
Arch Intern Med 2001;161:1379-1380.
FULL TEXT  

Optimization of {beta}-Quantification Methods for High-Throughput Applications
Cole et al.
Clin. Chem. 2001;47:712-721.
ABSTRACT | FULL TEXT  

Elevated Circulating Levels of Monocyte Chemoattractant Protein-1 in Patients With Restenosis After Coronary Angioplasty
Cipollone et al.
Arterioscler. Thromb. Vasc. Bio. 2001;21:327-334.
ABSTRACT | FULL TEXT  

Choose a Diet That Is Low in Saturated Fat and Cholesterol and Moderate in Total Fat: Subtle Changes to a Familiar Message
Dixon and Ernst
J. Nutr. 2001;131:510S-526.
ABSTRACT | FULL TEXT  

Distribution of ApoA-I-Containing HDL Subpopulations in Patients With Coronary Heart Disease
Asztalos et al.
Arterioscler. Thromb. Vasc. Bio. 2000;20:2670-2676.
ABSTRACT | FULL TEXT  

Lipid concentrations and the use of lipid lowering drugs: evidence from a national cross sectional survey
Primatesta and Poulter
BMJ 2000;321:1322-1325.
ABSTRACT | FULL TEXT  

Lipid screening to prevent coronary artery disease: a quantitative evaluation of evolving guidelines
Grover et al.
CMAJ 2000;163:1263-1269.
ABSTRACT | FULL TEXT  

A Reference Method Laboratory Network for Cholesterol: A Model for Standardization and Improvement of Clinical Laboratory Measurements
Myers et al.
Clin. Chem. 2000;46:1762-1772.
ABSTRACT | FULL TEXT  

Application of the National Cholesterol Education Program and joint European treatment criteria and clinical benefit in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS)
Gotto et al.
Eur Heart J 2000;21:1627-1633.
ABSTRACT  

Comparative Cholesterol Lowering Properties of Vegetable Oils: Beyond Fatty Acids
Wilson et al.
J. Am. Coll. Nutr. 2000;19:601-607.
ABSTRACT | FULL TEXT  

Short-term effect of atorvastatin in hypercholesterolaemic renal-transplant patients unresponsive to other statins
Romero et al.
Nephrol Dial Transplant 2000;15:1446-1449.
ABSTRACT | FULL TEXT  

Platelet Reactivity in Depressed Patients Treated With Paroxetine: Preliminary Findings
Musselman et al.
Arch Gen Psychiatry 2000;57:875-882.
ABSTRACT | FULL TEXT  

Arterial Mechanical Changes in Children With Familial Hypercholesterolemia
Yacine Aggoun et al.
Arterioscler. Thromb. Vasc. Bio. 2000;20:2070-2075.
ABSTRACT | FULL TEXT  

Long-Term Effects on Clinical Outcomes of Aggressive Lowering of Low-Density Lipoprotein Cholesterol Levels and Low-Dose Anticoagulation in the Post Coronary Artery Bypass Graft Trial
Knatterud et al.
Circulation 2000;102:157-165.
ABSTRACT | FULL TEXT  

Effects of Protease Inhibitors on Hyperglycemia, Hyperlipidemia, and Lipodystrophy: A 5-Year Cohort Study
Tsiodras et al.
Arch Intern Med 2000;160:2050-2056.
ABSTRACT | FULL TEXT  

3 Year simvastatin treatment and lens nuclear back scattering
Qian et al.
Br J Ophthalmol 2000;84:512-516.
ABSTRACT | FULL TEXT  

Gemfibrozil, nicotinic acid and combination therapy in patients with isolated hypoalphalipoproteinemia: a randomized, open-label, crossover study
Zema
J Am Coll Cardiol 2000;35:640-646.
ABSTRACT | FULL TEXT  

The Lipid Treatment Assessment Project (L-TAP): A Multicenter Survey to Evaluate the Percentages of Dyslipidemic Patients Receiving Lipid-Lowering Therapy and Achieving Low-Density Lipoprotein Cholesterol Goals
Pearson et al.
Arch Intern Med 2000;160:459-467.
ABSTRACT | FULL TEXT  

Prevention Conference V : Beyond Secondary Prevention : Identifying the High-Risk Patient for Primary Prevention : Medical Office Assessment : Writing Group I
Grundy et al.
Circulation 2000;101 :e3-e11.
FULL TEXT  

Safety considerations of polyunsaturated fatty acids
Eritsland
Am. J. Clin. Nutr. 2000;71:197S-201S.
ABSTRACT | FULL TEXT  

Preventing Coronary Artery Disease by Lowering Cholesterol Levels: Fifty Years From Bench to Bedside
Steinberg and Gotto
JAMA 1999;282:2043-2050.
ABSTRACT | FULL TEXT  

Effect of cholesterol lowering treatment on positive exercise tests in patients with hypercholesterolaemia and normal coronary angiograms
Mansur et al.
Heart 1999;82:689-693.
ABSTRACT | FULL TEXT  

Colesevelam Hydrochloride (Cholestagel): A New, Potent Bile Acid Sequestrant Associated With a Low Incidence of Gastrointestinal Side Effects
Davidson et al.
Arch Intern Med 1999;159:1893-1900.
ABSTRACT | FULL TEXT  

Essential fatty acids in health and chronic disease
Simopoulos
Am. J. Clin. Nutr. 1999;70:560S-569.
ABSTRACT | FULL TEXT  

Persistence of Increased Cardiovascular Risk in Patients with Cushing's Disease after Five Years of Successful Cure
Colao et al.
J. Clin. Endocrinol. Metab. 1999;84:2664-2672.
ABSTRACT | FULL TEXT  

Effects of Different Forms of Dietary Hydrogenated Fats on Serum Lipoprotein Cholesterol Levels
Lichtenstein et al.
NEJM 1999;340:1933-1940.
ABSTRACT | FULL TEXT  

Criteria, performance and diagnostic problems in diagnosing acute otitis media
Jensen and Lous
Fam Pract 1999;16:262-268.
ABSTRACT | FULL TEXT  

Genetic differences in cholesterol absorption in 129/Sv and C57BL/6 mice: effect on cholesterol responsiveness
Jolley et al.
Am. J. Physiol. Gastrointest. Liver Physiol. 1999;276:G1117-G1124.
ABSTRACT | FULL TEXT  

Use of Aspirin, {beta}-Blockers, and Lipid-Lowering Medications Before Recurrent Acute Myocardial Infarction: Missed Opportunities for Prevention?
McCormick et al.
Arch Intern Med 1999;159:561-567.
ABSTRACT | FULL TEXT  

Lowering LDL Cholesterol : Questions From Recent Meta-Analyses and Subset Analyses of Clinical Trial DataIssues From the Interdisciplinary Council on Reducing the Risk for Coronary Heart Disease, Ninth Council Meeting
Gotto and Grundy
Circulation 1999;99 :e1-e7.
ABSTRACT | FULL TEXT  

Risk Factor Modification in Stroke Prevention : The Experience of a Stroke Clinic
Joseph et al.
Stroke 1999;30:16-20.
ABSTRACT | FULL TEXT  

The National Cholesterol Education Program: Progress and Prospects
Cleeman and Lenfant
JAMA 1998;280:2099-2104.
ABSTRACT | FULL TEXT  

Benefit of a Favorable Cardiovascular Risk-Factor Profile in Middle Age with Respect to Medicare Costs
Daviglus et al.
NEJM 1998;339:1122-1129.
ABSTRACT | FULL TEXT  

Time Trends in the Use of Cholesterol-Lowering Agents in Older Adults: The Cardiovascular Health Study
Lemaitre et al.
Arch Intern Med 1998;158:1761-1768.
ABSTRACT | FULL TEXT  

Physician Noncompliance With the 1993 National Cholesterol Education Program (NCEP-ATPII) Guidelines
Frolkis et al.
Circulation 1998;98:851-855.
ABSTRACT | FULL TEXT  

Nurse-Mediated Cholesterol Management Compared With Enhanced Primary Care in Siblings of Individuals With Premature Coronary Disease
Becker et al.
Arch Intern Med 1998;158:1533-1539.
ABSTRACT | FULL TEXT  

Effects of Diet and Exercise in Men and Postmenopausal Women with Low Levels of HDL Cholesterol and High Levels of LDL Cholesterol
Stefanick et al.
NEJM 1998;339:12-20.
ABSTRACT | FULL TEXT  

Plasma Viscosity and the Risk of Coronary Heart Disease : Results From the MONICA-Augsburg Cohort Study, 1984 to 1992
Koenig et al.
Arterioscler. Thromb. Vasc. Bio. 1998;18:768-772.
ABSTRACT | FULL TEXT  

Systematic review of dietary intervention trials to lower blood total cholesterol in free-living subjects • Commentary: Dietary change, cholesterol reduction, and the public health---what does meta-analysis add?
Tang et al.
BMJ 1998;316:1213-1220.
ABSTRACT | FULL TEXT  

Dietary Fatty Acids and the Regulation of Plasma Low Density Lipoprotein Cholesterol Concentrations
Dietschy
J. Nutr. 1998;128:444-444.
ABSTRACT | FULL TEXT  

Cholesterol-Lowering Therapy in Women and Elderly Patients With Myocardial Infarction or Angina Pectoris : Findings From the Scandinavian Simvastatin Survival Study (4S)
Miettinen et al.
Circulation 1997;96:4211-4218.
ABSTRACT | FULL TEXT  

Cholesterol Management in Theory and Practice
Gotto
Circulation 1997;96:4424-4430.
ABSTRACT | FULL TEXT  

Long-term Cholesterol-Lowering Effects of 4 Fat-Restricted Diets in Hypercholesterolemic and Combined Hyperlipidemic Men: The Dietary Alternatives Study
Knopp et al.
JAMA 1997;278:1509-1515.
ABSTRACT  

Evidence Supporting Cholesterol-Lowering Therapy for Postmenopausal Women With Heart Disease
Goldstein
JAMA 1997;278:633-633.
ABSTRACT  

Evidence Supporting Cholesterol-Lowering Therapy for Postmenopausal Women With Heart Disease-Reply
Schrott et al.
JAMA 1997;278:633-634.
ABSTRACT  

Probucol and Multivitamins in the Prevention of Restenosis after Coronary Angioplasty
Tardif et al.
NEJM 1997;337:365-372.
ABSTRACT | FULL TEXT  

Cholesterol and Coronary Heart Disease: The 21st Century
Grundy
Arch Intern Med 1997;157:1177-1184.
ABSTRACT  

Self-Efficacy as a Predictor of Dietary Change in a Low-Socioeconomic-Status Southern Adult Population
Shannon et al.
Health Educ Behav 1997;24:357-368.
ABSTRACT  

Relation of High TG–Low HDL Cholesterol and LDL Cholesterol to the Incidence of Ischemic Heart Disease: An 8-Year Follow-up in the Copenhagen Male Study
Jeppesen et al.
Arterioscler. Thromb. Vasc. Bio. 1997;17:1114-1120.
ABSTRACT | FULL TEXT