Focus on multiple risk factors

Raises persons with diabetes but without CHD to the risk level of CHD risk equivalent

Uses Framingham projections of 10-year absolute CHD risk to identify patients with multiple (2 or more) risk factors for more intensive treatment

Identifies persons with metabolic syndrome as candidates for intensified therapeutic lifestyle changes

Modification of lipid/lipoprotein classification

Optimal LDL cholesterol level is now <100 mg per dL (2.60 mmol per L)

Increases categorical low HDL cholesterol level to <40 mg per dL (1.05 mmol per L)

Lowers triglyceride classification cut points

Support for implementation

Recommends complete lipoprotein profile (total, LDL, HDL, triglycerides) as preferred screening for assessing CHD risk status

Encourages use of plant sterols/stanols as a therapeutic dietary option to lower LDL cholesterol levels

Presents strategies for adherence to therapeutic lifestyle changes and drug therapies

Recommends treatment beyond LDL lowering for triglyceride levels >200 mg per dL (2.26 mmol per L)

One diet recommended for the entire population

12-week trial of diet alone before adding pharmacotherapy