Impact of the Third Cholesterol Report from the Adult Treatment Panel of the National Cholesterol Education Program on the Clinical Laboratory (Special Report‪)‬

Clinical laboratories will be affected by the new updated guidelines for prevention and management of high cholesterol in adults, the third Adult Treatment Panel Report (ATP III), [4] released in May by the National Cholesterol Education Program (NCEP). A summary has been published in JAMA (1) and is available on the National Heart, Lung, and Blood Institute website (www.nhlbi.nih.gov) together with a more detailed report (2) and other related resource materials. ATP III recommendations are solidly based on accumulating evidence concerning the contribution of lipoproteins and other risk factors in development of coronary heart disease (CHD) (3) and are more consistent with emerging international consensus (4, 5), for example, in increased emphasis on the risk associated with high triglycerides (TGs) (6). Treatment efforts still focus primarily on treating LDL-cholesterol (LDL-C) but include other important changes, including more effective lifestyle changes and considerable expansion of indications for drug therapy. The NCEP was organized in 1985 to develop practice guidelines and educate both the general public and the medical community about the need to identify and treat high cholesterol in ameliorating CHD risk. Expert panels were convened to develop recommendations for clinical practice, public health programs, and laboratory measurements. The NCEP expert laboratory panels published recommendations for standardization and analytic performance targets for lipid and lipoprotein measurements. The initial reports summarized the current status and provided recommendations for total cholesterol (TC) analytic performance (7, 8). Three later reports provided guidelines for measuring LDL-C (9), HDL-cholesterol (HDL-C) (10), and TGs (11).