According to the ATP III guidelines, when is non-HDL cholesterol used as the initial target of LDL-lowering medication?

Updated: Dec 19, 2019
  • Author: Mary Ellen T Sweeney, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

If the secondary conditions that raise triglyceride levels cannot be managed successfully and if triglycerides are 200-499 mg/dL, the non–high-density lipoprotein (HDL) cholesterol (total cholesterol – HDL) can be used as the initial target of using LDL-lowering medication (see Table 3, below). The non–HDL cholesterol is the sum of the cholesterol carried by the atherogenic lipoproteins, LDL, very low-density lipoprotein (VLDL), and intermediate-density lipoprotein (IDL). The goals for non–HDL levels, similar to those for LDL levels, are dependent on risk and are 30 mg/dL higher than the corresponding LDL goals.

Table 3. Classification of LDL Cholesterol and Non-HDL Cholesterol (Open Table in a new window)

Classification

LDL Goal,

mg/dL

Non-HDL Goal,

mg/dL

CHD and CHD risk equivalent, diabetes mellitus, and the following:

10-year risk for CHD >20%

< 100

< 130

Two or more risk factors and the following:

10-year risk < 20%

< 130

< 160

0-1 risk factor

< 160

< 190

CHD = coronary heart disease; LDL = low-density lipoprotein; HDL = high-density lipoprotein.

Source:  National Cholesterol Education Program. Executive summary of 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). JAMA. May 16 2001;285(19):2486-97. [14]


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