Guideline for diagnosis and management of hyperlipidemia for prevention of atherosclerosis in Japan

Coronary heart disease (CHD) mortality and plasma cholesterol level have increased in Japan. There has been evidence indicating that cholesterol-lowering is effective in secondary and primary prevention of CHD. Hypercholesterolemia has been defined as over 220 mg/dl, and over 140 mg/dl for LDL-cholesterol. These levels were determined on the base of the evidence observed in Japan. The subjects are divided as follows, A: no CHD and no other risk factors, B: no CHD and at least one risk factor, C: manifest CHD. The treatment levels of LDL-cholesterol are 140 mg/dl for category A, 120 mg/dl for B and 100 mg/dl for C. Although drug therapy may be necessary when LDL-cholesterol level is over 120 mg/dl in category C, life-style modification is most important in category A and B.