WHAT EVERY DOCTOR WANTS TO KNOW ABOUT CHOLESTEROL - ANSWERS TO SOME DIFFICULT QUESTIONS

1. Opportunistic screening by the primary health care team is more cost effective than mass screening. 2. Ideally all adults should have a cholesterol measurement. 3. Dietary counselling should be offered, following European Atherosclerosis Society guidelines. 4. Drug treatment should be preceded by multiple lipid measurements and full dietary management. 5. Where logistic or other considerations limit initial cholesterol screening programmes, preference should be given to individuals with known CHD, those with a family history of premature CHD or of hyperlipidaemia, those with other known CHD risk factors, to older rather than younger persons, and to males before females. 6. Screening should be for all risk factors. 7. Intervention should not be on one, but on all modifiable risk factors. 8. Drug usage for hypercholesterolaemia should follow consideration of an individual's overall CHD risk and not just a single factor. Careful drug choice is cost effective.