Report of the Japan Atherosclerosis Society (JAS) Guideline for Diagnosis and Treatment of Hyperlipidemia in Japanese adults.

This paper described the Guideline for Diagnosis and Management of Hyperlipidemias for Prevention of Atherosclerosis proposed by The Japan Atherosclerosis Society (JAS) Guideline Investigating Committee (1,995-2,000) under the auspices of the JAS Board of Directors. 1) The guideline defines the diagnostic criteria for serum total cholesterol (Table 1), LDL-cholesterol (Table 1), triglycerides (Table 4) and HDL-cholesterol (Table 7). It also indicates the desirable range (Table 1), the initiation levels of management (Table 2) and the target levels of treatment (Table 2) for total and LDL-cholesterol. 2) Though both total and LDL-cholesterol are shown as atherogenic parameter in the guideline, the use of LDL-cholesterol, rather than total cholesterol, is encouraged in daily medical practice and lipid-related studies, because LDL-cholesterol is more closely related to atherosclerosis. 3) Elevated triglycerides and low HDL-cholesterol are included in the risk factors, since no sufficient data have been accumulated to formulate the guideline for these two lipid disorders. 4) Emphasis is laid on evaluation of risk factors of each subject before starting any kind of treatment (Table 2). 5) This guideline is applied solely for adults (age 20-64). Lipid abnormalities in children or the youth under age 19, and the elderly with an age over 65 have to be evaluated by their own standard. 6) This part of the guideline gives only the diagnostic aspects of hyperlipidemias. The part of management and treatment will follow in the second section of the guideline that will be published in future.

[1]  H. Keen,et al.  The Bedford Survey: Ten year mortality rates in newly diagnosed diabetics, borderline diabetics and normoglycaemic controls and risk indices for coronary heart disease in borderline diabetics , 1982, Diabetologia.

[2]  S. Yamashita,et al.  Genetic cholesteryl ester transfer protein deficiency is extremely frequent in the Omagari area of Japan. Marked hyperalphalipoproteinemia caused by CETP gene mutation is not associated with longevity. , 1997, Arteriosclerosis, thrombosis, and vascular biology.

[3]  Y. Yazaki,et al.  Suppression of diet-induced atherosclerosis in low density lipoprotein receptor knockout mice overexpressing lipoprotein lipase. , 1996, Proceedings of the National Academy of Sciences of the United States of America.

[4]  A. Tall,et al.  Increased coronary heart disease in Japanese-American men with mutation in the cholesteryl ester transfer protein gene despite increased HDL levels. , 1996, The Journal of clinical investigation.

[5]  K. Satomura,et al.  Target Levels for Plasma Lipids in Patients with Coronary Artery Disease: ―動脈硬化(冠・末梢)のある例で― , 1996 .

[6]  H. Mabuchi Current State of and Recent Trends in Serum Lipid Levels in the General Japanese Population , 1996 .

[7]  S. Kihara,et al.  Atherosclerotic disease in marked hyperalphalipoproteinemia. Combined reduction of cholesteryl ester transfer protein and hepatic triglyceride lipase. , 1995, Arteriosclerosis, thrombosis, and vascular biology.

[8]  T. Tamada,et al.  [Age at natural menopause in Japanese women]. , 1995, Nihon Sanka Fujinka Gakkai zasshi.

[9]  L. Coupal,et al.  The cost-effectiveness of HMG-CoA reductase inhibitors to prevent coronary heart disease. Estimating the benefits of increasing HDL-C. , 1995, JAMA.

[10]  S. Grundy Atherogenic dyslipidemia: lipoprotein abnormalities and implications for therapy. , 1995, The American journal of cardiology.

[11]  S. Yamashita,et al.  Molecular Defect and Atherogenicity in Cholesteryl Ester Transfer Protein Deficiency , 1994, Annals of the New York Academy of Sciences.

[12]  D. B. Zilversmit Atherogenic nature of triglycerides, postprandial lipidemia, and triglyceride-rich remnant lipoproteins. , 1995, Clinical chemistry.

[13]  J. Auget,et al.  Comparative study of risk factors in patients undergoing coronary or femoropopliteal artery bypass grafting. , 1994, British heart journal.

[14]  L. Martens,et al.  Cost-effectiveness analysis of lipid-modifying therapy in Canada: comparison of HMG-CoA reductase inhibitors in the primary prevention of coronary heart disease. , 1994, Clinical therapeutics.

[15]  F. Follath,et al.  Plasma triglycerides and three lipoprotein cholesterol fractions are independent predictors of the extent of coronary atherosclerosis. , 1994, Circulation.

[16]  Y. Stein Comparison of European and USA guidelines for prevention of coronary heart disease. , 1994, Atherosclerosis.

[17]  R. Krauss Heterogeneity of plasma low‐density lipoproteins and atherosclerosis risk , 1994, Current opinion in lipidology.

[18]  P. Poole‐Wilson,et al.  Prevention of coronary heart disease in clinical practice. Recommendations of the Task Force of the European Society of Cardiology, European Atherosclerosis Society and European Society of Hypertension. , 1994, European heart journal.

[19]  J. Patsch,et al.  Triglyceride-rich lipoproteins and atherosclerosis. , 1994, Atherosclerosis.

[20]  W. A. Bradley,et al.  Cellular binding site and membrane binding proteins for triglyceride-rich lipoproteins in human monocyte-macrophages and THP-1 monocytic cells. , 1994, Journal of lipid research.

[21]  J. Després,et al.  Relation of components of insulin resistance syndrome to coronary disease risk. , 1994, Current opinion in lipidology.

[22]  T Nakamura,et al.  Contribution of visceral fat accumulation to the development of coronary artery disease in non-obese men. , 1994, Atherosclerosis.

[23]  A. Folsom,et al.  High-density lipoprotein cholesterol and premature coronary heart disease in urban Japanese men. , 1994, Circulation.

[24]  C. Packard,et al.  Role of plasma triglyceride in the regulation of plasma low density lipoprotein (LDL) subfractions: relative contribution of small, dense LDL to coronary heart disease risk. , 1994, Atherosclerosis.

[25]  L. Wilkins National Cholesterol Education Program. Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). , 1994 .

[26]  E. Schaefer,et al.  Familial lipoprotein disorders and premature coronary artery disease. , 1993, The Medical clinics of North America.

[27]  Y. Yamasaki,et al.  Insulin Resistance Accelerates Atherosclerosis in Borderline Diabetes. , 1994 .

[28]  Bradley Wa,et al.  Triglyceride-rich lipoproteins and atherosclerosis: pathophysiological considerations. , 1994 .

[29]  M. Uusitupa,et al.  Long-term effects of three fat-modified diets in hypercholesterolemic subjects. , 1994, Atherosclerosis.

[30]  J. Hokanson,et al.  Epidemiology of triglycerides, small dense low-density lipoprotein, and lipoprotein(a) as risk factors for coronary heart disease. , 1994, The Medical clinics of North America.

[31]  L. Wilkins,et al.  National Cholesterol Education Program. Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). , 1994, Circulation.

[32]  G. Hallmans,et al.  High serum insulin, insulin resistance and their associations with cardiovascular risk factors The Northern Sweden MONICA population study , 1993, Journal of internal medicine.

[33]  P. Marckmann,et al.  Dietary effects on circadian fluctuation in human blood coagulation factor VII and fibrinolysis. , 1993, Atherosclerosis.

[34]  J. Mckenney,et al.  Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II) , 1993, JAMA.

[35]  K. Frayn Insulin resistance and lipid metabolism , 1993 .

[36]  R. Krauss,et al.  Susceptibility of small, dense, low-density lipoproteins to oxidative modification in subjects with the atherogenic lipoprotein phenotype, pattern B. , 1993, The American journal of medicine.

[37]  Reckless Jp Cost-effectiveness of hypolipidaemic drugs. , 1993 .

[38]  P. Wilson,et al.  Change in LDL particle size is associated with change in plasma triglyceride concentration. , 1992, Arteriosclerosis and thrombosis : a journal of vascular biology.

[39]  M. Sentí,et al.  Lipoprotein and Apolipoprotein Profile in Men With Ischemic Stroke: Role of Lipoprotein (a), Triglyceride‐Rich Lipoproteins, and Apolipoprotein E Polymorphism , 1992, Stroke.

[40]  C. Kurata,et al.  Coronary artery disease in patients with arteriosclerosis obliterans of the lower extremities or aortic aneurysm. , 1992, Internal medicine.

[41]  R. Langer,et al.  Mortality over a period of 10 years in patients with peripheral arterial disease. , 1992, The New England journal of medicine.

[42]  T. Fujinami,et al.  Relation of Serum Lipid Levels to the Presence and Severity of Angiographic Coronary Artery Disease in Japanese , 1992 .

[43]  S. Grundy,et al.  Two different views of the relationship of hypertriglyceridemia to coronary heart disease. Implications for treatment. , 1992, Archives of internal medicine.

[44]  R. Krauss,et al.  Inhibition of early atherogenesis in transgenic mice by human apolipoprotein AI , 1991, Nature.

[45]  J. Salonen,et al.  Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. , 1991, Arteriosclerosis and thrombosis : a journal of vascular biology.

[46]  R. DeFronzo,et al.  Insulin Resistance: A Multifaceted Syndrome Responsible for NIDDM, Obesity, Hypertension, Dyslipidemia, and Atherosclerotic Cardiovascular Disease , 1991, Diabetes Care.

[47]  M. Austin Plasma triglyceride and coronary heart disease. , 1991, Arteriosclerosis and thrombosis : a journal of vascular biology.

[48]  D. Steinberg,et al.  Role of oxidised low density lipoprotein in atherogenesis. , 1993, British heart journal.

[49]  N. Ohte,et al.  Coronary risk factors in angiographically defined patients with chest pain. , 1990, Japanese journal of medicine.

[50]  M. King,et al.  Atherogenic lipoprotein phenotype. A proposed genetic marker for coronary heart disease risk. , 1990, Circulation.

[51]  A. Shiraishi,et al.  Relationship between coronary risk factor and arteriographic feature of coronary atherosclerosis. , 1990, Japanese circulation journal.

[52]  K. Kodama,et al.  Trend of coronary heart disease and its relationship to risk factors in a Japanese population: a 26-year follow-up, Hiroshima/Nagasaki study. , 1990, Japanese circulation journal.

[53]  V. Fuster,et al.  Regression of atherosclerotic lesions by high density lipoprotein plasma fraction in the cholesterol-fed rabbit. , 1990, The Journal of clinical investigation.

[54]  H. Shimano,et al.  Apolipoprotein E and lipoprotein lipase secreted from human monocyte-derived macrophages modulate very low density lipoprotein uptake. , 1990, The Journal of biological chemistry.

[55]  J W Hay,et al.  Medical costs of coronary artery disease in the United States. , 1990, The American journal of cardiology.

[56]  J. Sasaki,et al.  Alcohol consumption, serum lipids and severity of angiographically determined coronary artery disease. , 1990, The American journal of cardiology.

[57]  M. Miller,et al.  Isolated low HDL-cholesterol as an important risk factor for coronary heart disease. , 1990, European heart journal.

[58]  J. Huttunen,et al.  Relation between baseline lipid and lipoprotein values and the incidence of coronary heart disease in the Helsinki Heart Study. , 1989, The American journal of cardiology.

[59]  S. Pocock,et al.  Concentrations of high density lipoprotein cholesterol, triglycerides, and total cholesterol in ischaemic heart disease. , 1989, BMJ.

[60]  R. L. Rogers,et al.  Reducing Hypertriglyceridemia in Elderly Patients with Cerebrovascular Disease Stabilizes or Improves Cognition and Cerebral Perfusion , 1989, Angiology.

[61]  P. Welling,et al.  The Clinical Pharmacokinetics of Quinapril , 1989, Angiology.

[62]  N. Kaplan The deadly quartet. Upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. , 1989, Archives of internal medicine.

[63]  D. Gordon,et al.  High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. , 1989, Circulation.

[64]  G. Rosenhamer,et al.  Reduction of mortality in the Stockholm Ischaemic Heart Disease Secondary Prevention Study by combined treatment with clofibrate and nicotinic acid. , 2009, Acta medica Scandinavica.

[65]  G. Reaven Role of Insulin Resistance in Human Disease , 1988, Diabetes.

[66]  M. Barbir,et al.  High prevalence of hypertriglyceridaemia and apolipoprotein abnormalities in coronary artery disease. , 1988, British heart journal.

[67]  G. Yoshino,et al.  Recommendation for Strict Control of Plasma Triglyceride in Diabetic Subjects , 1988, Diabetes Care.

[68]  W. A. Bradley,et al.  Distinct murine macrophage receptor pathway for human triglyceride-rich lipoproteins. , 1988, The Journal of clinical investigation.

[69]  W C Willett,et al.  Low-density lipoprotein subclass patterns and risk of myocardial infarction. , 1988, JAMA.

[70]  W. Castelli,et al.  Cholesterol and lipids in the risk of coronary artery disease--the Framingham Heart Study. , 1988, The Canadian journal of cardiology.

[71]  A. Rimm,et al.  RELATION OF TRIGLYCERIDE LEVELS TO CORONARY ARTERY DISEASE: THE MILWAUKEE CARDIOVASCULAR DATA REGISTRY , 1988 .

[72]  P. Wilson,et al.  High Density Lipoprotein Cholesterol, Total Cholesterol Screening, and Myocardial Infarction: The Framingham Study , 1988, Arteriosclerosis.

[73]  C. Fielding,et al.  Early incorporation of cell-derived cholesterol into pre-beta-migrating high-density lipoprotein. , 1988, Biochemistry.

[74]  Daniel Steinberg,et al.  Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. The Expert Panel. , 1988, Archives of internal medicine.

[75]  J. Reiber,et al.  Progression and regression of human coronary atherosclerosis. The role of lipoproteins, lipases and thyroid hormones in coronary lesion growth. , 1987, Atherosclerosis.

[76]  P. Vague,et al.  Relationships between plasma insulin triglyceride, body mass index, and plasminogen activator inhibitor 1. , 1987, Diabete & metabolisme.

[77]  Y. Matsuzawa,et al.  Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. , 1987, Metabolism: clinical and experimental.

[78]  P. Wilson,et al.  Incidence of coronary heart disease and lipoprotein cholesterol levels. The Framingham Study. , 1986, JAMA.

[79]  J. Neaton,et al.  Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). , 1986, JAMA.

[80]  F. Cambien,et al.  Is the level of serum triglyceride a significant predictor of coronary death in "normocholesterolemic" subjects? The Paris Prospective Study. , 1986, American journal of epidemiology.

[81]  W. Castelli,et al.  The triglyceride issue: a view from Framingham. , 1986, American heart journal.

[82]  H. Mabuchi,et al.  Causes of death in patients with familial hypercholesterolemia. , 1986, Atherosclerosis.

[83]  L. Simons Interrelations of lipids and lipoproteins with coronary artery disease mortality in 19 countries. , 1986, The American journal of cardiology.

[84]  M. Kameyama,et al.  Lp(a) lipoprotein as a risk factor for coronary heart disease and cerebral infarction. , 1986, Atherosclerosis.

[85]  M. Blombäck,et al.  Haemostatic function in myocardial infarction. , 1986, British heart journal.

[86]  M. Blombäck,et al.  Increased plasma levels of a rapid inhibitor of tissue plasminogen activator in young survivors of myocardial infarction. , 1985, The New England journal of medicine.

[87]  R. Mahley,et al.  Lipoproteins of Special Significance in Atherosclerosis , 1985 .

[88]  K. Hiwada,et al.  Clinical significance of measurements of serum apolipoprotein A-I, A-II and B in hypertriglyceridemic male patients with and without coronary artery disease. , 1985, Atherosclerosis.

[89]  P A Wolf,et al.  Risk factors for stroke. , 1985, Stroke.

[90]  S. Grundy,et al.  Comparison of effects of dietary saturated, monounsaturated, and polyunsaturated fatty acids on plasma lipids and lipoproteins in man. , 1985, Journal of lipid research.

[91]  Y. Matsuzawa,et al.  Increased frequency of lipoprotein disorders similar to type III hyperlipoproteinemia in survivors of myocardial infarction in Japan. , 1984, Atherosclerosis.

[92]  S. Eisenberg,et al.  Plasma triglyceride determines structure-composition in low and high density lipoproteins. , 1984, Arteriosclerosis.

[93]  E. Agner,et al.  Fasting serum cholesterol and triglycerides in a ten-year prospective study in old age. , 2009, Acta medica Scandinavica.

[94]  H. Sekimoto,et al.  Changes of serum total cholesterol and triglyceride levels in normal subjects in Japan in the past twenty years. Research committee on familial hyperlipidemia in Japan. , 1983, Japanese circulation journal.

[95]  J. Little,et al.  The role of lipoprotein lipase in the metabolism of triglyceride-rich lipoproteins by macrophages. , 1983, The Journal of biological chemistry.

[96]  M. Feinleib,et al.  Serum Triglyceride and Risk of Coronary Heart Disease, Stroke, and Total Mortality in Japanese‐American Men , 1983, Arteriosclerosis.

[97]  R. Gregg,et al.  Type III Hyperlipoproteinemia: Diagnosis, Molecular Defects, Pathology, and Treatment , 1983 .

[98]  Y. Matsuzawa,et al.  Coronary artery disease in heterozygous familial hypercholesterolemia. , 1982, Atherosclerosis.

[99]  S. Grundy,et al.  Influence of polyunsaturated fats on composition of plasma lipoproteins and apolipoproteins. , 1982, Journal of lipid research.

[100]  W. A. Bradley,et al.  Hypertriglyceridemic very low density lipoproteins induce triglyceride synthesis and accumulation in mouse peritoneal macrophages. , 1982, The Journal of clinical investigation.

[101]  S. Daniels,et al.  Cerebrovascular arteriopathy (arteriosclerosis) and ischemic childhood stroke. , 1982, Stroke.

[102]  B. Lewis,et al.  Relationships between the metabolism of high‐density and very‐low‐density lipoproteins in man: studies of apolipoprotein kinetics and adipose tissue lipoprotein lipase activity , 1982, European journal of clinical investigation.

[103]  M. Hamada,et al.  Plasma lipids and lipoproteins in Japanese male patients with coronary artery disease and in their relatives. , 1982, Atherosclerosis.

[104]  W. Kannel,et al.  Lipoproteins, cardiovascular disease, and death. The Framingham study. , 1981, Archives of internal medicine.

[105]  L Wilhelmsen,et al.  Multivariate Analyses of Serum Apolipoproteins and Risk Factors in Relation to Acute Myocardial Infarction , 1981, Arteriosclerosis.

[106]  M. Kameyama,et al.  Lipoprotein Abnormalities in the Pathogenesis of Cerebral Infarction and Transient Ischemic Attack , 1981, Stroke.

[107]  G. Heiss,et al.  The Epidemiology of Plasma High‐density Lipoprotein Cholesterol Levels: The Lipid Research Clinics Program Prevalence Study Summary , 1980, Circulation.

[108]  L. Wilhelmsen,et al.  Alpha-lipoprotein cholesterol concentration in relation to subsequent myocardial infarction in hypercholesterolemic men. , 1980, Atherosclerosis.

[109]  M. Shipley,et al.  CORONARY-HEART-DISEASE RISK AND IMPAIRED GLUCOSE TOLERANCE The Whitehall Study , 1980, The Lancet.

[110]  R. Bawol,et al.  Epidemiology as a guide to clinical decisions. The association between triglyceride and coronary heart disease. , 1980, The New England journal of medicine.

[111]  A. Keys,et al.  Seven countries. A multivariate analysis of death and coronary heart disease. , 1980 .

[112]  S. Shapiro,et al.  Association of coronary atherosclerosis with hyperapobetalipoproteinemia [increased protein but normal cholesterol levels in human plasma low density (beta) lipoproteins]. , 1980, Proceedings of the National Academy of Sciences of the United States of America.

[113]  D. B. Zilversmit Atherogenesis: a postprandial phenomenon. , 1979, Circulation.

[114]  K. Pyörälä Relationship of Glucose Tolerance and Plasma Insulin to the Incidence of Coronary Heart Disease: Results from Two Population Studies in Finland , 1979, Diabetes Care.

[115]  J. Medalie,et al.  High density lipoprotein cholesterol and incidence of coronary heart disease--the Israeli Ischemic Heart Disease Study. , 1979, American journal of epidemiology.

[116]  T. Welborn,et al.  Coronary Heart Disease Incidence and Cardiovascular Mortality in Busselton with Reference to Glucose and Insulin Concentrations , 1979, Diabetes Care.

[117]  S. Matsushita,et al.  High and low density lipoprotein cholesterol in myocardial and cerebral infarction. , 1979, Atherosclerosis.

[118]  S. Rössner,et al.  Dyslipoproteinemia in patients with ischemic cerebro-vascular disease: a study of stroke before the age of 55. , 1978, Atherosclerosis.

[119]  C. Packard,et al.  Effects of dietary polyunsaturated and saturated fat on the properties of high density lipoproteins and the metabolism of apolipoprotein A-I. , 1978, The Journal of clinical investigation.

[120]  M C Hjortland,et al.  High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study. , 1977, The American journal of medicine.

[121]  R. Worth,et al.  Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California. Coronary heart disease risk factors in Japan and Hawaii. , 1977, The American journal of cardiology.

[122]  A. Motulsky,et al.  Myocardial infarction in the familial forms of hypertriglyceridemia. , 1976, Metabolism: clinical and experimental.

[123]  J. Meyer,et al.  Hyperlipoproteinemia in occlusive cerebrovascular disease. , 1975, JAMA.

[124]  W. Kannel,et al.  Role of Lipids in the Development of Brain Infarction: The Framingham Study , 1974, Stroke.

[125]  P. McNamara,et al.  Morbidity and Mortality in Diabetics In the Framingham Population: Sixteen Year Follow-up Study , 1974, Diabetes.

[126]  A. Motulsky,et al.  Hyperlipidemia in coronary heart disease. II. Genetic analysis of lipid levels in 176 families and delineation of a new inherited disorder, combined hyperlipidemia. , 1973, The Journal of clinical investigation.

[127]  R. Farmer,et al.  Hyperlipoproteinemia and pancreatitis. , 1973, The American journal of medicine.

[128]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[129]  G. Odland,et al.  Evidence for the chylomicron origin of lipids accumulating in diabetic eruptive xanthomas: a correlative lipid biochemical, histochemical, and electron microscopic study. , 1970, The Journal of clinical investigation.

[130]  J. Glomset,et al.  The plasma lecithins:cholesterol acyltransferase reaction. , 1968, Journal of lipid research.

[131]  M. Albrink,et al.  Serum triglycerides in coronary artery disease. , 1958, Transactions of the Association of American Physicians.