© 2003 Canadian Medical Association or its licensors

Clinical practice guidelines require continual re-assessment in response to new information andchanges in the pattern of disease. Challenges in Canada, as in all industrialized countries, include the in-creasing size of the elderly population and the rising preva-lence of obesity and diabetes mellitus. More than 20 % of Canadians will be over 65 years of age by 2011. Obesity, particularly abdominal adiposity, is associated with an in-creased prevalence of diabetes, hypertension and other fea-tures of the metabolic syndrome (hypertriglyceridemia, low levels of high-density lipoprotein cholesterol [HDL-C] and insulin resistance). Currently, 31 % of Canadian adults are obese (defined as a body mass index greater than 27 kg/m2). Type 2 diabetes is a major risk factor for coronary artery disease, and its prevalence is reaching epidemic propor-tions. The First Nations population, with a risk of diabetes 3 to 5 times higher than that of the general Canadian pop-ulation, is at particular risk. Because of the burden of cardiovascular disease and the high rate of death from out-of-hospital acute myocardial infarction, preventive measures are essential in order to re-duce health care costs and improve the health of Canadi-ans. The Working Group on Hypercholesterolemia and Other Dyslipidemias issued recommendations for the man-agement and treatment of dyslipidemias in Canada in 2000.1 Since the publication of these Canadian guideline