Where to draw the line against cholesterol

Article Abstract:

The Toronto Working Group on Cholesterol Policy recently issued new guidelines for the detection and treatment of hypercholesterolemia, or high blood cholesterol levels, and these recommendations are compared with those from the National Cholesterol Education Program (NCEP). Although the Toronto Working Group does not address the management of persons with coronary artery disease, both groups have similar guidelines for management of persons without symptoms. The Toronto guidelines generally reflect the NCEP objectives, but focus on higher-risk persons such as those between 35 and 59 years with one of the following risk factors: cigarette smoking, hypertension (high blood pressure), diabetes mellitus, obesity, or a family history of hypercholesterolemia or coronary artery disease. They would also test persons out of this age range who have at least two risk factors, as well as persons with an interest in knowing their cholesterol level and willing to change their diet if necessary. The range of values of total cholesterol and low density lipoprotein (LDL) considered acceptable by the Toronto group is not as narrow as the NCEP. Less selective guidelines may result in fewer persons with hypercholesterolemia being detected and treated, leading to development of more cases of coronary artery disease. However, the Toronto group argues that their guidelines are more cost-effective, and that persons without symptoms do not generally benefit from cholesterol reduction. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Standards, Diagnosis, Measurement, Low density lipoproteins, Blood cholesterol, Hypercholesterolemia, editorial

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Cost-effectiveness of screening for carotid stenosis in asymptomatic persons

Article Abstract:

It does not appear to be cost-effective to routinely screen older men for evidence of stroke. Researchers used a statistical model to evaluate the cost-effectiveness of routinely screening otherwise healthy 65-year-old men for evidence of blockage in the major blood vessel supplying the head. An acceptable cost per year of life saved is generally considered to be $50,000. This stroke screening procedure would cost $120,000 per year of life saved. Unrealistic conditions would have to occur for the cost per year of life saved to approach $50,000.

Economic aspects, Ultrasound imaging, Prevention, Stroke (Disease), Stroke, Arteries, Endarterectomy, Carotid artery, Carotid arteries, Arterial stenosis

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Low-Molecular-Weight Heparins Compared with Unfractionated Heparin for Treatment of Acute Deep Venous Thrombosis

Article Abstract:

Low-molecular-weight heparins may be equally effective or more so than regular heparin in the treatment of deep venous thrombosis. This condition occurs when blood clots form in the major veins of the legs. An analysis of 11 studies that compared low-molecular-weight heparins with regular heparin found that the use of low-molecular-weight heparins lowered mortality rates and did not cause excess bleeding complications. It was also as effective as regular heparin in preventing a recurrence of deep vein thrombosis.

Evaluation, Drug therapy, Thrombosis, Deep vein, Deep vein thrombosis, Heparin

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