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23-01-2012 | Cardiometabolic | Article

Low awareness of NCEP-ATP-III non-HDL cholesterol guidelines among physicians


Free abstract

MedWire News: A large number of physicians in training are not familiar with the National Cholesterol Education Adult Treatment Panel (NCEP-ATP)-III guidelines for non-high-density lipoprotein (non-HDL) cholesterol, show study findings.

"One-third of these physicians-in-training could not calculate non-HDL cholesterol levels from a standard lipid panel, and almost two-thirds are not aware of non-HDL cholesterol treatment goals," report Salim Virani (Baylor College of Medicine, Houston, Texas, USA) and colleagues.

"In addition, two-thirds of the physicians-in-training do not calculate non-HDL cholesterol levels in their patients with elevated [triglycerides] as recommended by the guidelines."

For the study, Virani and team developed and administered a survey to assess the knowledge, attitudes, and practice of physicians-in-training towards non-HDL cholesterol guidelines.

Responses of those practicing in internal and family medicine (n=418; residents-in-training) were compared with those in cardiology and endocrinology (n=124; fellows-in-training)

As reported in the Journal of Clinical Lipidology, the response rate was 83.7% among 655 trainees who were administered the survey.

Approximately 50% of residents and 30% of fellows had not read the NCEP-ATP-III guidelines, and a respective 67% and 52% were not aware of treatment goals for non-HDL cholesterol.

The NCEP-ATP-III guidelines endorse non-HDL cholesterol as a secondary treatment target among patients with elevated triglycerides (≥200 mg/dL [2.26 mmol/L]) after attainment of low-density lipoprotein cholesterol goals. However, both residents and fellows reported infrequent calculation of non-HDL cholesterol levels in these patients (32.5 and 35.4%, respectively).

In addition, 33% of residents and 35% of fellows-in training could not calculate non-HDL cholesterol from a standard lipid panel.

Reasons cited by participants as barriers to the use of non-HDL cholesterol in routine clinical practice included a lack of familiarity with the guidelines, lack of awareness that non-HDL cholesterol levels are important in cardiovascular risk reduction, lack of an institutional mandate for calculating non-HDL cholesterol, and a lack of emphasis on non-HDL cholesterol by the teaching staff.

"These gaps represent areas for improvement, especially if non-HDL cholesterol is to be retained as a treatment target in the forthcoming ATP-IV guidelines," concludes the team.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Nikki Withers