The American College of Physicians (ACP), in the March 1 issue of Annals of Internal Medicine,1 proposes new guidelines for cholesterol testing for the prevention of coronary heart disease in adults. These guidelines differ substantially from those initially proposed2 and later revised3 by the National Cholesterol Education Program (NCEP) Adult Treatment Panel, endorsed by the American Heart Association (AHA), and from the previous American College of Physicians guidelines. It should be noted that the NCEP/AHA guidelines were reviewed and endorsed by representatives of more than 40 organizations, including the American College of Physicians. The Task Force on Risk Reduction of the AHA is concerned about the detrimental effects to the general public, to high-risk patients, and to their physicians that may emanate from this proposed modification in American College of Physicians guidelines for cholesterol testing. A review of the flaws in advocating change in the NCEP/AHA guidelines as currently widely accepted and implemented is presented here.