Evaluating CMR

The NCEP-ATP III Statement of 2001

The third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III or ATP III) was published in 2001 to provide updated guidelines for cholesterol testing and management (1, 2). The primary objective of this document was to demonstrate that patients with coronary heart disease (CHD) could benefit from intensive cholesterol-lowering treatment, while suggesting that special focus be placed on primary prevention in persons with multiple risk factors (other than elevated LDL cholesterol) in order to prevent CHD. These risk factors include traditional factors such as age, gender, total and HDL cholesterol, smoking, hypertension, family history of premature CHD, and diabetes without CHD. NCEP-ATP III was also the first to recognize the importance of the metabolic syndrome and identify it as a secondary target of risk-reduction therapy after the primary target, LDL cholesterol.

Several authors have proposed that abdominal obesity should be considered the underlying cause or, at least, the most prevalent form of the metabolic syndrome (3, 4). Linked to upper-body obesity, the metabolic syndrome is also associated with a cluster of metabolic abnormalities such as atherogenic dyslipidemia (elevated triglyceride and apolipoprotein B, low HDL cholesterol, and the presence of small, dense LDL and HDL particles), a pro-inflammatory and pro-thrombotic profile, insulin resistance, and elevated blood pressure. NCEP-ATP III sets out clinical criteria to help health professionals diagnose the metabolic syndrome in clinical practice.