Abstract
The targets of lipid lowering therapy in Japan are severer than those in western countries. Two hundred twenty mg⁄dl for total cholesterol (TCH), 140mg⁄dl for LDL-C, 150 mg⁄dl for triglyceride (TG) are used for the target values. In western countries, those values are 270 mg⁄dl, 190 mg⁄dl and 1,000 mg⁄dl respectively for low risk persons. But, a morbidity rate of coronary heart disease in Japan is a third in western countries. Strange to say, the number of women who accepts the therapy is twice of that of men in Japan. We have verified the targets used in Japan by some kinds of studies. We established clinical reference intervals of TCH, LDL-C, TG and HDL-C from the results of health checkup of about 700,000 persons by the method comparable to NCCLS in USA. We performed cohort studies and found cutoff points where mortalities increased significantly. These results are equal to the targets used in western countries. People diagnosed as hyperlipidemia by Japanese standard have less morbidity of strokes. If they develop strokes, their clinical indexes are better than persons in normal lipid level. In conclusion, the guideline for hyperlipidemia in Japan should be revised according to Japanese evidences soon.
