Attitudes of attending physicians to the incidental diagnosis of hypercholesterolemia in hospitalized patients

The National Cholesterol Education Program has recently updated its recommendations for evaluation and treatment of hypercholesterolemia.6 These new recommendations put additional emphasis on the presence of CAD and older age for selecting candidates for lipid-lowering drugs. Young men (< 35 years old) and premenopausal women are now manageable with diet therapy only, unless they have very high cholesterol levels and diabetes mellitus, or a family history of premature CAD. The low percentage of patients with hypercholesterolemia that should be treated, who actually received therapy in our study (only 14%), includes those receiving recommendations for lipid-lowering diet or drugs. Therefore, most patients would be classified as not getting appropriate treatment even if judged by the newer standards.