A Review of the 2005 Clinical Practice Guidelines for the Management of Dyslipidemia in the Philippines


  • Deborah Ignacia Ona
  • Lourdes Ella Gonzalez- Santos
  • Rosa Allyn Sy


Cardiovascular disease is a leading cause of mortality in the Philippines with an upward trend in the prevalence of
atherosclerosis-related risk factors. In the national survey done in 2008, the prevalence of dyslipidemia is also
increasing. As such, there is a need to increase awareness of the risk factors for cardiovascular disease among health
care professionals. The development of Philippine guidelines were part of the strategy to improve overall cardiovascular
risk and dyslipidemia management that is relevant to the Philippine setting. This article summarizes the 2005
Dyslipidemia guidelines, discusses some updates since its release and emphasizes equity issues when considering
management of dyslipidemia in a Filipino patient.


Download data is not yet available.


The International Clinical Epidemiology Network (INCLEN). Knowledge management plus: The INCLEN guideline development cycle. Available at www.inclentrust.org. Accessed on April 2014.

Health Statistics: Leading cause of mortality and morbidity. Department of Health Website. Available at http://www.doh.gov.ph/node/198.html. Accessed on April 15, 2014.

Sy RG, Morales DD, Dans AL, Paz-Pacheco E, Punzalan FER, Abelardo NS, Duante CA. Prevalence of atherosclerosis-related risk factors and diseases in the Philippines. J Epidemiol 2012;22(5):440-447. http://dx.doi.org/10.2188/jea.JE20110095.

Dans AL, Morales DD, Velandria F, Abola TB, Rozas JR, Punzalan FER, SYS Rg, Paz-Pacheco E, for the NNHes: 2003 Group. National Nutrition and Health Survey (NNHes): Atherosclerosis-related diseases and risk factors. Phil J Int Med 2005;43:103-115.

Wilhemsen L. Coronary Heart Disease: Epidemiology of smoking and intervention studies of smoking. Am Heart J 1988;115:242-249.http://dx.doi.org/10.1016/0002-8703(88)90644-8.

The Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on detection Evaluation and Treatment of High Blood cholesterol in Adults (Adult Treatment Panel III). Bethesda, MD: National Institutes of Health; 2002. NIH Publication NO 02-5215.

Yusuf S, Hawken S, Ounpuu S, et al. Effect of modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case control study. Lancet. 2004-2005;364:937-952.

Regional Office for the Western Pacific of the World Health Organization, the International Association for the Study of Obesity and the International Obesity Task Force. The Asia-Pacific perspective: Redefining obesity and its treatment. Health Communications Australia Pty Limited. February 2000.

Blair SN, Cooper KH, Gibbons LW, et al. Changes in coronary heart disease risk factors associated with increased treadmill time in 753 men. N Eng J Med. 1993;328:538-545.

King H, Krista AM. Prevention of Type II diabetes in physical training: Epidemiological considerations and study methods. Diabetes Care. 1992;15 (Supp 4): 1794-1799.

Helmrich Sp, Ragland DR, Leung RW, Paffenbarger RS Jr. Physical activity and reduced occurrence of non –insulin dependent diabetes mellitus. N Eng J Med. 1191; 325:147-152.

Haskell WL, Akderman EL, Fair JM et al. Effects of multiple risk factor reduction in coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease: The Stanford Coronary Risk Intervention Project (SCRIP). Circulation 1994;89:975-990. http://dx.doi.org/10.1161/01.CIR.89.3.975.

Leon AS, Connett J, Jacobs DR Jr., et al. Leisure time physical activity levels and risk of coronary heart disease and death: The Multiple Risk Factor Intervention Trial. JAMA. 1987;258:2388-2395. http://dx.doi.org/10.1001/jama.1987.03400170074026.

Ekelund LG, Haskell WL, Johnson JL, et al. Physical Fitness as a predictor of cardiovascular mortality in asymptomatic North American men: The Lipid Research Clinics Mortality Follow-up study. N Engl J Med. 1988;319:1379-1384. http://dx.doi.org/10.1056/NEJM198811243192104.

Blain SN, Kohl HW 3rd, Paffenbarger RS Jr, et al. Physical Fitness and All Cause Mortality : A prospective study of healthy men and women. JAMA. 1989:262:2395-2401.

Morris JN, Clayton DG, Everitt MG, et al. Exercise in leisure time: Coronary attack and death rates. Br Heart J. 1990;63:325-332. http://dx.doi.org/10.1136/hrt.63.6.325.

Sandvik l, Erikssen J, Thaulow E, et al. Physical Fitness as a predictor of mortality among healthy, middle aged Norweigian men. N Engl J Med. 1993:328:533-537.

Paffenbarger RS Jr, Hyde RT, Wing AL, et al. The association of changes in physical activity level and other lifestyle characteristics with mortality in men. N Engl J Med. 1993;328:538-545. http://dx.doi.org/10.1056/NEJM199302253280804.

Working Group Report on Management of Patients with Hypertension and High Blood Cholesterol. National Working Group Programs Working Group Report on Management of Patients with Hypertension and High Blood Cholesterol. Ann Intern Med. 1991;114:224-237.

Cutler JA, Psaty BM, MacMahon S, et al. Public Health Issues in hypertension control: What has been learned from clinical trials. In : Laragh JH, Brenner BM, eds. Hypertension: pathophysiology, diagnosis and management. 2nd ed New York. Raven Press, 1995:253-270.

Hooper L, Summerbell CD, Higgins JPT, et al. Reduced or modified dietary fat for preventing cardiovascular disease (Cochrane Review). In: The Cochrane Library, Issue 2, 2004-2005. Chichester ,UK; John Wiley & Sons Ltd.

Clarke R, Frost C, Collins R, et al. Dietary lipids and blood cholesterol quantitative analysis of metabolic ward studies. BMJ. 1997;314:112-117.


Mersink RP, Katan MB. Effect of dietary fatty acids on serum lipid and lipoproteins. Arteriosclerosis Thrombosis. 1992;12:911-919. http://dx.doi.org/10.1161/01.ATV.12.8.911.

The Biomedical Nutrition Research Division, Food and Nutrition Research Institute Department of Science and Technology. Nutritional Guidelines for Filipinos: Revised Edition 2000. Taguig: Food and Nutrition Research Institute; 2000.

Downs JR, Clearfield M, Weis S, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: Results of AFCAPS/TexCAPS. JAMA. 1998;279:1615-1622. http://dx.doi.org/10.1001/jama.279.20.1615.

Shepherd J, Cobbe SM, Ford I, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med. 1995;333:1301-1307. http://dx.doi.org/10.1056/NEJM199511163332001.

Frick MH, Elo MO, Haapa K, et al. Helsinki Heart Study; primary prevention trial with gemfibrozil in middle aged men with dyslipidemia: Safety of treatment, changes in risk factors and incidence of coronary heart disease. N Engl J Med. 1987;317:1237-1245.


The Lipid Research Clinics Coronary Primary Prevention Trial Results II. The relationship of the reduction in incidence of coronary heart disease. JAMA.1984;251:351-364.

Sever PS, Dahlof B, Poulter NR, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower than average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcome Trial-Lipid Lowering Arm (ASCOT-LLA): A multicenter randomized controlled trial. Lancet. 2003;361:1149-1158.


The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs. usual care . The Anti-Hypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial. JAMA 2002;288:2998-3007.

Collins R, Armitage J, Parish S, et al. MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes; A randomized placebo control trial. Lancet. 2003; 361;2005-2016.

Shepherd J, Blauw GJ, Murphy MB et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): A randomized control trial. Lancet. 2002; 360: 1623-1630. http://dx.doi.org/10.1016/S0140-6736(02)11600-X.

Calhoun HM, Betteridge DJ, Durrington PN, et al. Primary Prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS); multicenter randomized placebo trial. Lancet. 2004-2005;364: 685-696.

Effect of fenofibrateon progression of coronary artery disease in type 2 diabetes: The Diabetes Atherosclerosis Intervention Study, a randomized study. Lancet. 2001;357:905-910. http://dx.doi.org/10.1016/S0140-6736(00)04209-4.

Elkeles RS, Diamond JR, Poulter C, et al. A double blind placebo controlled study of bezafibrate: the St Mary's, Ealing, Northwick, Park Diabetes Cardiovascular Disease Prevention (SEND CAP) Study . Diabetes Care. 1998;21: 641-648. http://dx.doi.org/10.2337/diacare.21.4.641.

Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol-lowering simvastatin in 5963 people with diabetes: A randomized placebo-controlled trial. Lancet. 2003; 361; 2005-2016.

Rubins HB, Robins SJ, Collins D, et al. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group. N Engl J Med. 1999; 341: 410-418. http://dx.doi.org/10.1056/NEJM199908053410604.

Secondary prevention by raising HDL and reducing triglycerides in patients with coronary artery disease: The Bezafibrate Infarction Prevention (BIP) study. Circulation 2000; 101: 21-27.

Sever PS, Dahlof B, Poulter NR, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcome Trial – Lipid Lowering Arm (ASCOT-LLA): A multicenter randomized controlled trial. Lancet. 2003; 361: 1149-1158.


Snow V, Aronsosn MD, Hornbake ER, et al. Lipid control in the management of type 2 diabetes mellitus: A clinical practice guideline for the American College of Physicians. Ann Intern Med. 2004; 140: 644-649.


Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol-lowering simvastatin in 20536 high risk individuals: A randomized placebo-controlled trial. Lancet. 2002; 360; 7-22.

Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4,444 patients with coronary heart disease: The Scandinavian Simvastatin Survival Study (4S). Lancet. 1994; 344:1383-1389.

Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) Study Group. Prevention of Cardiovascular Events and death in pravastatin patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med. 1998; 339; 1349-1357.

Sacks FM, Pfeffer MA, Moye LA, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Eng J Med. 1996;335: 1001 – 1009.


LaRosa JC, Grundy SM, Waters DD, et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med. 2005; 352:1425-1435. http://dx.doi.org/10.1056/NEJMoa050461.

Cannon CP, Braunwald E, McCabe CH, et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med. 2004; 350: 1495-1504. http://dx.doi.org/10.1056/NEJMoa040583.



How to Cite

Ona, D. I., Santos, L. E. G.-., & Sy, R. A. (2014). A Review of the 2005 Clinical Practice Guidelines for the Management of Dyslipidemia in the Philippines. Journal of the ASEAN Federation of Endocrine Societies, 29(2), 116. Retrieved from https://www.asean-endocrinejournal.org/index.php/JAFES/article/view/159



Feature Articles

Most read articles by the same author(s)