Cholesterol issues and management

The aim of this Minisymposium is to address current cholesterol issues as viewed from the United States. During the past decade the term ‘cholesterol’ has become a household word in the US. This fact can be attributed in large to the efforts of the National Cholesterol Education Program (NCEP). This program has wide support from a large number of member organizations such as the American Heart Association, the American College of Cardiology, and the American Medical Association. The NCEP has developed programs in both public health and professional education. NCEP efforts have led to increased public and professional awareness of high blood cholesterol as a major risk factor for coronary heart disease, to increased testing for high cholesterol levels, to modification of the American diet, and to increased use of cholesterol‐lowering drugs. The use of drugs has been supported by the recent publication of three major clinical trials: the Scandinavian Simvastatin Survival Study, the West of Scotland Coronary Prevention Study, and the Cholesterol and Recurrent Events study. All three of these trials demonstrated a major reduction in coronary risk accompanying aggressive cholesterol‐lowering therapy. They have been highly influential in thinking about cholesterol management in high‐risk patients in the US. This Minisymposium considers various issues related to primary and secondary prevention, cholesterol management in special populations, and the problem of adherence to medication.