In May 2001, the National Cholesterol Education Program (NCEP) issued important clinical cholesterol guidelines. This update was the first in ten years, and was prepared with hopes of helping adults manage their cholesterol levels, and prevent an increase.

In cooperation with the National Heart, Lung and Blood Institute, the NCEP used research and study results to develop new cholesterol guidelines. These updated guidelines show significant changes in the following areas:

* An increase in more insistent cholesterol-reducing treatments

* The identification of patients posing a high risk of heart disease

* A new stage at which low HDL, or low high-density lipoprotein, can pose a major high risk factor for heart disease

* New therapeutic lifestyle changes that can increase the ability to improve cholesterol levels

* A greater focus on the cluster of heart disease risk factors known as "the metabolic syndrome", as related to insulin resistance

* Greater awareness concerning the treatment, and more aggressive treatment of high triglycerides.

By following these guidelines, the NCEP anticipated a considerable increase in the number of Americans undergoing treatment for high cholesterol. These numbers, in fact, did increase. The number of patients taking dietary treatments rose from 52 million to 65 million. In addition, an estimated 36 million patients were taking cholesterol-reducing drugs, up from the previous number of 13 million.

In the 2001 report, it was shown that diabetes poses a high risk of heart disease. The report also suggested that people with diabetes should undergo the same intensive treatment as those suffering with heart disease. These suggested treatments include both lifestyle changes and medications.

As a result of the new cholesterol guidelines, there is now a widely used tool that can help to predict a patient's chance of developing heart disease within a ten-year span. The tool can calculate the risk of women and men separately. It is highly recommended by a group called the Adult Treatment Patients (ATP), and is used to assess patients who present two or more risk factors of heart disease.

Other changes presented in the new cholesterol guidelines include:

* A better high cholesterol treatment for diabetics. People with Type 2 diabetes face a high short-term risk of having a coronary episode, and a higher risk of suffering a fatal heart attack.

* The use of a lipoprotein profile as the first step in testing for high cholesterol. This profile is the measurement of the levels of HDL, LDL, total cholesterol, triglycerides and other fatty substances found in the bloodstream.

* Increased use of nutrition, weight control and physical activity to act as treatments of high blood cholesterol levels.

* Identifying the "metabolic syndrome" of the risk factors as related to insulin resistance.

* Advising patients to stop using hormone replacement therapy (HRT) as a substitute for cholesterol-reducing medicines.

Over the ten year span, major advances were realized in the treatment of high cholesterol. Thanks to the findings of the 2001 National Cholesterol Education Program, we have a greater understanding of the effects of high cholesterol, and doctors are able to take advantage of better treatment options.