As research continues in the field of coronary artery disease, more information is revealed about various etiological factors. Emerging lipoprotein risk factors have been identified and are now starting to surface as instrumental in the cause and prevention of coronary artery disease. In order to conduct comprehensive cholesterol screening programs and counseling sessions a health professional must have a thorough understanding of lipid metabolism. Recent changes in cholesterol guidelines make it necessary to have a review that addresses the specifics of lipid management. A health professional needs an appropriate knowledge base to be able to understand a major coronary artery disease risk factor and thereby more effectively educate the public about lipid management and coronary artery disease risk reduction. Therefore, the purpose of this article is to review the role of cholesterol in both normal physiological functioning and disease causation and to examine the research concerning new emerging cholesterol risk factors.
Cholesterol Screening and the Health Professional
Recommendations by the National Cholesterol Education Program (NCEP) suggest that all Americans over the age of twenty should have their cholesterol concentrations measured (National Heart, Lung, and Blood Institute [NHLBI], 2003). An estimated 70.8% of the US population twenty years and older had participated in cholesterol screening at least once by the year 2000. This is a substantial increase from the mid-1980s when 35% had been screened at least once (Brown, Giles, Greenlund, & Croft, 2001). A number of health education programs have an emphasis on cholesterol screening followed by counseling with a health professional. Through these screenings health professionals can have a significant impact on cardiovascular disease outcomes by being involved in primary and secondary prevention, raising awareness, and successfully referring participants to physicians for further testing (Bowden, Kingery, & Brizzolara, 1999; Muratova, Islam, Demerath, Minor, & Neal 2001). In order to conduct comprehensive cholesterol screening programs and counseling sessions, health professionals must have a thorough understanding of coronary artery disease (CAD) risk factors which includes lipid metabolism (Ostwald, Weiss-Farnan, & Monson, 1990). Since the most important aspect of cholesterol screening is the action the participants take after receiving their screening results (Garber & Browner, 1997), having accurate and up-to-date information on the role of cholesterol in CAD enables health professionals to effectively develop and implement prevention programs, educate the public, and make referrals (Sullivan, 2002). Recent changes in cholesterol guidelines make it necessary to have a review that addresses the specifics of lipid management and CAD prevention. Therefore, the purpose of this paper is to review the role of cholesterol in both normal physiological functioning and disease causation and to examine the latest research concerning the new emerging cholesterol risk factors of CAD.