The National Heart, Lung, and Blood Institute created the National Cholesterol Education Program
(NCEP)1 to establish guidelines for the diagnosis and
treatment of hypercholesterolemia. Despite widespread acceptance of those guidelines, certain components have been questioned and argued extensively2
(ie, deemphasis on high-density lipoprotein cholesterol
levels as a useful risk measurement, lack of specific
age and sex guidelines, and the difficulty in obtaining
accurate serum lipid level measurements). The reports
by Bookstein et al3 and Mogadam et al4 in this issue of
the Archives examine the extent to which analytical
and biological variables may affect the reliability and
reproducibility of repeated serum lipid measurements
and the accuracy of the classification of risk for any
given individual. These articles also address the feasibility of the implementation of NCEP guidelines in
light of their findings. (A recent NCEP publication
also addresses these concerns in considerable detail.5)
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